PETRUSHKA

PETRUSHKA: Personalising Antidepressant Treatment for Unipolar Depression

 

PETRUSHKA

Antidepressants are one of the main treatments for depression. Many patients, however, are given antidepressants, which prove ineffective or cause stressful side effects for them as individuals. This happens because antidepressants are prescribed without a clear understanding of which drug is the most appropriate medication for each patient. Regulatory bodies and guidelines developers have recommended prioritizing the improvement of antidepressant treatment for depression, but this advice has not yet been translated into practice. We suggest we already have sufficient evidence to distinguish between treatments according to personal characteristics, and the preferences and values of patients themselves. People with a diagnosis of depression often need additional support during the consultation visit when they make decisions about starting a new course of treatment. By a more careful analysis of existing data, we can better tailor the choice of a specific drug to a specific person (“personalized medicine”), to increase the chances that the drug will be tolerable and effective. We developed the PETRUSHKA tool, an evidence-based online system which will help doctors and patients together choose the best antidepressant for each individual with moderate to severe symptoms of depression. For the first time, this system will bring together the best available scientific information with the preferences of patients to provide a bespoke clinical decision aid for antidepressant treatment. The PETRUSHKA tool will be tested in a scientifically sound study of depressed patients who are to be treated with antidepressants in both primary and secondary care across Brazil, Canada and the UK. During the project, patients and carers have been involved in the co-development of the PETRUSHKA tool, which provides a model that can be extended to non-pharmacological treatments and to other psychiatric and non-psychiatric disorders, such as schizophrenia, diabetes and epilepsy.

 

Website: https://petrushka-trial.org/accounts/login/

RSE: Matt Jaquiery

Collaborators: Department of Psychiatry

 

Publications

  • Ostinelli, E. G., Jaquiery, M., Liu, Q., Elgarf, R., Haque, N., Potts, J., Li, Z., Efthimiou, O., Markham, S., Ede, R., Wainwright, L., Fernandes, K. B. P., Fernandes, B. B. P., Dalaqua, P. V. C., Tomlinson, A., Smith, K. A., Zangani, C., De Crescenzo, F., Liboni, M., … Cipriani, A. (2025). Personalising Antidepressant Treatment for Unipolar Depression Combining Individual Choices, Risks and big Data: The PETRUSHKA Tool: Personnalisation du traitement antidépresseur de la dépression unipolaire associant choix individuels, risques et mégadonnées: l’outil PETRUSHKA. The Canadian Journal of Psychiatry. https://doi.org/10.1177/07067437251322399

News Articles