Shifting the Paradigm in Psychiatric Care
Psychiatry is entering a period defined by a search for biological precision rather than the traditional, often exhausting, process of trial and error. For many patients living with schizophrenia, the path to finding an effective treatment involves cycling through multiple antipsychotic medications, a process that can last months or years. Some individuals suffer significant side effects, including heart inflammation, during these attempts to stabilize their condition.
The Fralin Biomedical Research Institute at VTC is hosting a Precision Therapeutics symposium on Sept. 23-24 to address these gaps. The event brings together pharmaceutical executives, neuroscientists, and clinicians to explore how computational models and biological markers might replace the guessing game that has long defined psychiatric prescribing. The goal is to identify specific biological differences among patients to guide treatment choices earlier in the process.
A New Mechanism for Treatment
Stephen Brannan, a physician-scientist who helped lead the development of the drug Cobenfy, suggests that the field is at an inflection point. Cobenfy represents a departure from standard antipsychotics, which have historically focused on blocking dopamine receptors. Instead, this new medication targets muscarinic cholinergic receptors, which are associated with cognitive functions like memory and perception.
While this represents a significant shift, Brannan emphasizes that the broader ambition is to understand why different patients respond to different drugs. Much like the introduction of SSRIs in the past, new pharmaceutical pathways are expected to emerge. The focus now is on using these tools to move beyond broad diagnostic categories and toward treatments tailored to individual biological profiles.
Bridging the Gap Between Laboratory and Clinic
Virginia Tech has built a foundation in computational psychiatry over the last decade, with faculty like Read Montague and Pearl Chiu utilizing neuroimaging and behavioral analysis to study brain function. Michael Halassa, a recent addition to the Fralin Biomedical Research Institute, is now extending this work into the Patient Research Center. This move aims to connect direct laboratory research with clinical application at the bedside.
Michael Friedlander, executive director of the institute, notes that the institution is uniquely positioned to bridge this divide. The institute combines molecular and cellular inquiry with large-scale human behavioral research. This cross-disciplinary approach allows researchers to observe how changes in functional brain circuitry correlate with symptoms, rather than simply suppressing those symptoms without understanding their root cause.
The Path to Definitive Treatment
Robert Trestman, chair of psychiatry at the Virginia Tech Carilion School of Medicine, observes that while many patients find relief with current standards of care, others continue to struggle without a clear path forward. The symposium intends to highlight biological and computational tools that could assist clinicians in making informed decisions. By using human causal data and direct measurement of neuromodulators, researchers hope to identify specific brain regions involved in psychosis more accurately.
Industry leaders from firms including Johnson & Johnson and AbbVie are slated to join the conversation, signaling a shift in how biotech companies are viewing psychiatric drug development. If the research succeeds, physicians may eventually rely on biological data to select the most effective treatment for a patient on the first attempt. This change would mark the beginning of a new era in psychopharmacology, where clinical decisions are anchored in measurable biological reality.