Research at Center for Psychopharmacology
The research at Center for Psychopharmacology is organized into the research group (unit) entitled “psychopharmacology@diakonsyk”, which performs many studies aiming to identify, validate, and/or implement biomarkers of individual variation in clinical effect and side effects of antidepressant and antipsychotic drugs. The knowledge from our research allows for personalized treatment of patients with psychiatric disorders based on factors such as pharmacogenetics, drug-drug interactions, lifestyle, gender, and age. The patient benefit is reduced risk of unsuccessful treatment, while for the society it implies cost savings related reduced hospitalizations, disabilities, sick leaves, and drug use.
Psychopharmacological medications represent the most commonly used treatment of psychiatric diseases. Although use of medications significantly helps many people suffering of psychiatric diseases, their use is also associated with frequent treatment failure and severe side effects, which per se may imply additional burden and costs both for patients and society. To maximize the utility of psychopharmacological treatment of psychiatric diseases, particularly depressive and psychotic disorders, precision medicine approaches are necessary. Precision medicine covers three aspects, i.e. i) identifying the right patients (correct diagnosis), ii) selecting the right treatments (e.g. appropriate medication), and iii) selecting the right dose of the medication.
The overall research strategy of Center for Psychopharmacology is to provide new knowledge improving the steps ii) and iii) defined above. This implies identification and evaluation of factors determining clinical effects and tolerability of key drugs used in treatment of psychiatric disorders, i.e. antidepressants and antipsychotics. As our biological understanding of psychiatric disorders has stagnated and merely been stand-still during the last 50 years, the goals are to obtain the best possible treatments of existing medications for individual patients (‘personalized treatment’) within the respective therapeutic fields. Center for Psychopharmacology has contributed and will continue contributing to increase our knowledge to achieve the ambitious goals of personalized treatment in psychiatry. The overall research strategy of Center for Psychopharmacology (CFP) is to fill gaps in knowledge necessary for implementing personalized medicine in psychiatry. By using data and material from our routine laboratory and clinical services, we run several research projects and participates in large research consortia.
Among the 28 regular employees at Center for Psychopharmacology, 13 (46 %) hold a PhD degree and are working partly or full-time on ongoing projects in the research group psychopharmacology@diakonsyk. Among the pool of PhDs in the group, four are affiliated to the University of Oslo or Oslo Metropolitan University as Professors or Associate Professors. In addition, psychopharmacology@diakonsyk hosts many PhD and master students.
During the period the last 10 years, 10 PhD students and 26 master students have graduated from the research group at Center for Psychopharmacology.
Another five PhD students are performing their projects, while two master students are working on their thesis. Three people in the research group are currently working as postdocs financed by external funding. In addition, two PhDs are working as Senior Researchers paid by the department.
The user organization ‘Mental Helse’ is represented by Kjersti Sunniva Bjøntegård. She is user representative in several ongoing projects at the Center for Psychopharmacology, and knows our research strategy, possible methodological approaches, opportunities, and limitations, very well. Bjøntegård has played an important role in bringing patient perspectives into the research projects and dissemination of the research findings. In our quarterly meetings she participates in discussions on results interpretations and potential new projects.
Center for Psychopharmacology has also established a reference group consisting of persons representing research, health care services, politics, social aspects, and user experiences. Members of the board are Prof. Emeritus Knut Engedal, former Mayor of Oslo Fabian Stang, an elderly patient representative, and user representative Kjersti Sunniva Bjøntegård. The reference group meets bi-annually and are particularly dedicated to our projects on psychiatric drug treatment of older patients.
Researchers at Center for Psychopharmacology are conducting several projects, either in-house or part of collaborations in international consortia. All projects comply with aims funded in our research strategy. Most projects are focused on individual variability in pharmacological responses related to use of antidepressants or antipsychotics. Detailed information about the various projects can be found in the Cristin profiles of the respective researchers.
Currently, the research group at Center for Psychopharmacology is part of three European consortia, which represent our prioritized research areas. Brief descriptions of the research aims/topics of the respective consortia, fundings sources and respective leaders/coordinators:
- Pharmacological variability of antipsychotic drugs and mechanisms of underlying treatment resistant schizophrenia. This research is clustered in the REALMENT consortium, which is funded by Horizon 2020 (grant number 964874) and led by Prof. Ole Andreassen (H-index 146) at the University of Oslo, Norway.
- Pharmacogenetics of antidepressants and multimodality associated with treatment of depression. This research is clustered in the ArtiPro consortium which is funded by the ERA-PerMed program (grant number ERAPERMED2021-357) and led by Prof. Julia Stingl (H-index 53) at the RWTH Aachen University, Germany.
- Discovery of new variants in pharmacogenes encoding the drug-metabolizing enzymes CYP2D6 and CYP2C19. This research is clustered in a small consortium which is funded by the Swedish Research Council (grant number 2021-02732) and led by Prof. Magnus Ingelman-Sundberg (H-index 128) at the Karolinska institutet in Stockholm, Sweden.
PI from Center for Psychopharmacology in all consortia is Prof. Espen Molden (H-index 40), leader of psychopharmacology@diakonsyk.
During the last 5 years, CFP has published 126 papers in PubMed-indexed scientific journals, typically ranging from IF 3 to 8 (increasing frequency of published papers in journals with IF >10).
See the list of publications between 2015 and 2023
One of the main strategies to reach out with and implement research from Center for Psychopharmacology is courses for healthcare professionals. Center for Psychopharmacology has for decades organized annual courses in psychopharmacology for psychiatrists and general practitioners. During the last years, two courses are arranged where one is most fit for psychiatrist, while the other is most appropriate for general practitioners.
The topic of the courses changes from year to year, but all are related to pharmacological treatment of psychiatric disorders. In all courses, regardless of topic, updates on (new) research findings from Center for Psychopharmacology are disseminated to the participants in a popular form to make the knowledge as applicable as possible for clinical practice and patient treatment. With this approach we ensure that knowledge from our research is implemented effectively as possible. Physicians from all around Norway are participating and many attends the course each year as the main topic is changing.
Typically, around 100 physicians attend the courses. One of the courses are held remote so that participation becomes flexible by electronical attendance. The courses mostly include lectures, but also group discussions on relevant cases. The courses are solely arranged by Center for Psychopharmacology, both the practical part and teaching activities. Researchers are responsible for holding lectures on issues of clinical relevance within the respective course topic. In addition, some basic lectures on pharmacogenetics, drug interaction and TDM held by Espen Molden are available for downloading as an online for those who wish to prime basic skills before attending the courses. Examples of course topics during recent years are ‘Toxicity of psychotropic drugs’ and ‘Treatment resistance of psychotropic drugs’.
Watch the lectures (youtube.com)
In addition to these annual, ‘voluntary’ courses, researchers at Center for Psychopharmacology are responsible for the teaching psychopharmacology for assistant doctors who are training to become specialists in psychiatry. This teaching is essential among our outreach strategies, as it perhaps is the most important path to implement translational knowledge from our research. We are responsible for teaching psychopharmacology to the assistant doctors in psychiatry at three hospitals in Oslo, i.e. Lovisenberg Hospital, Diakonhjemmet Hospital and Oslo University Hospital.
Another outreaching strategy is to initiate and implement solutions for the use of our analytical test results in clinical decision support on drug prescribing. Within the field of pharmacogenetics, Center for Psychopharmacology was the first in Norway to establish genotyping of cytochrome P450 (CYP) enzymes as a tool for personalized dosing of antidepressants and antipsychotics, but also somatic drugs, as these enzymes metabolize a lot of drugs across a range of different therapeutic areas. The test results are life-long, and it is therefore important that the CYP genotype ‘follows’ the patients through the healthcare system for possible re-use. To obtain re-use of the test results, Center for Psychopharmacology worked together with the Directorate of E-health to innovate a system for digital storage of variant genotypes as critical information in “Kjernejournal”, a personal medical record for universal use across healthcare institutions. This solution is promoted via our interpretated lab reports to physicians requesting genotyping. Since we are doing a lot of research on the impact and value of pharmacogenetic testing, innovation of this electronic system for decision support is an effective way of reaching out with clinical recommendations founded on our own research. As a result of this project, Center for Psychopharmacology is now cooperating with the Norwegian Directorate of Health to develop solutions enabling implementation of pharmacogenetic testing in primary healthcare in Norway, which in an important step in implementing state-of-the-art pharmacogenetic knowledge for precision drug prescribing.
Finally, an important outreaching strategy is to collaborate with our user representative in disseminating popularized information from our research directly to patients and patient organizations. However, this part of our strategies needs to be further developed to be successful.