Riccardo De Giorgi

I am a Wellcome Trust Doctoral Training Fellow (DPhil in Biomedical and Clinical Sciences) at the University of Oxford, Department of Psychiatry, and a honorary Clinical Fellow (MRCPsych) at the Oxford Health NHS Foundation Trust.

My focus is on academic psychiatry and I am interested in the evidence-based treatment of mental illness, especially within the themes of psychopharmacology and mood disorders. I am fascinated by the problem of "treatment-resistance", i.e. when patients do not appear to respond to several lines of therapy. The physiopathological heterogeneity underlying treatment-resistance highlights the need for mechanistically dissimilar approaches to resolve this problem; in other words, I propose to apply the "precision medicine" paradigm to treatment-resistance.
For example, there is increasing evidence that inflammation plays a role in the pathophysiology of depression, especially in patients who are treatment-resistant. Indeed, part of the heterogeneous clinical responses to treatment in depression could be accounted for by a subgroup of patients with baseline inflammation. Therefore, anti-inflammatory treatments may particularly benefit those patients who respond poorly to conventional antidepressants and who might be identifiable a priori through measurement of inflammatory markers.

Currently, I am working on an experimental medicine study on the use of anti-inflammatory drugs in patients with treatment-resistant depression and elevated inflammation. I aim to use early markers of anti-depressant response, such as changes in emotional processing and reward measured by behavioural tasks and brain imaging, to validate the potential of these drugs in further clinical trials.