Eric Ruhé Appointed as Professor of Difficult-to-Treat Depression 

Psychiatrist Eric Ruhé has been appointed Professor of Difficult-to-Treat Depression at Radboud university medical center / Radboud University. His research focuses on individuals with treatment-resistant depression, aiming to improve and personalize care for this vulnerable patient group. 

A depression is considered Difficult-to-Treat when multiple treatments have insufficient effect or when individuals repeatedly relapse. At Radboudumc, psychiatrist and epidemiologist Eric Ruhé sees patients with this complex condition on a weekly basis. His close involvement in clinical practice enables him to conduct research that is closely aligned with real-world challenges. 'I see firsthand what patients and clinicians are struggling with', says Ruhé. With his appointment as professor, he aims to improve care for this vulnerable group, reduce the stigma surrounding depression, and contribute to more effective, personalized treatment strategies for people whose depression persists or recurs despite treatment.

Brain networks

In addition to his clinical work, Ruhé conducts fundamental research into brain networks involved in depression. 'We see that brain regions involved in emotion, self-reflection, and reward processing work together less effectively in people with depression', he explains. His team uses advanced models of dynamic brain connectivity, such as turbulence analysis and effective connectivity, to map how brain regions influence each other. 'With computer simulations, we aim to test how treatments affect these networks and determine which therapy best suits each individual patient.'

Artificial Intelligence

Using artificial intelligence, Ruhé and his colleagues are developing models to predict whether an antidepressant will be effective and whether a new depressive episode is likely to occur. 'It’s very discouraging for patients when a treatment doesn’t work or when depression returns. This field is still in its infancy, but in a recent study, we showed that AI, applied to  clinical data and brain scans, can provide a reasonable estimate of antidepressant effectiveness', says Ruhé. Together with researchers in Nijmegen and Amsterdam UMC, he plans to continue this work.

Medication research

Esketamine nasal spray is a new treatment for people with Difficult-to-Treat depression, used only when previous treatments have failed. Unlike traditional antidepressants, esketamine targets a different system in the brain, offering new opportunities, according to Ruhé. Radboudumc coordinates a national collaboration involving over thirty Dutch treatment centers that prescribe esketamine. Ruhé: 'The exciting thing is that we are now collecting data together. We have data from around 600 patients, which allows us to better investigate when and for whom this treatment is an effective alternative to previous unsuccessful treatments.'

In the TEMPO study, Ruhé and colleagues from Amsterdam UMC are investigating strategies for tapering off antidepressants after successful treatment. 'We still know little about who can stop, when, and how best to do so after a successful course of antidepressants. This study compares different tapering schedules in terms of withdrawal symptoms, seeking solid evidence for rational and well-founded advice', says Ruhé. 'We are also examining whether the tapering method influences the likelihood of relapse of depression.'

Career

Eric Ruhé studied Medicine at the University of Amsterdam, followed by additional training in epidemiology at Vrije Universiteit. He then specialized in psychiatry at the Academic Medical Center (AMC), where he started as a staff member in 2003. He obtained his PhD in 2008 with research on the effectiveness and neurobiological effects of dose escalation of antidepressants (thesis title: Dose-escalation in the picture: pharmacological and imaging studies in depression). He later worked at UMC Groningen and was a visiting senior researcher at the University of Oxford. Since 2017, he has been working at Radboudumc and is also affiliated with the Donders Institute. He played a key role in developing the new Dutch multidisciplinary Guideline for Depression (2024). Ruhé is also active internationally within the International Society of Affective Disorders and the European College of Neuropsychopharmacology. In that context, he leads a DELPHI study aimed at reaching consensus on various (translational) dimensions of depression. His appointment as professor began on July 1 and will last for five years.

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