After developing an AI tool that recommends antidepressants based on medical history, George Mason University researchers are now examining whether additional patient demographics, such as race and ethnicity, can improve the tool’s effectiveness. The answer is yes, according to their new research.
An interdisciplinary George Mason University team led by Farrokh Alemi , an expert in machine-learning and AI, compared how effective recommendations were from AI-guided tools/models that knew the patient’s race and factors uniquely relevant to African American patients against tools/models that didn’t. The team found that recommendations based on “race-blind” AI models—those that do not know the patient’s race—tended to recommend medications that were less effective for African American patients.
“Anti-depressant recommendations from race-specific models outperformed recommendations from general models across all antidepressants studied. The findings highlight why clinical AI, like clinical practice, shouldn't rely solely on general-population patterns when prescribing for African Americans with depression,” said Vladimir Cardenas, master of science in health informatics ’24.
Why This Matters
“If AI systems are not trained on correct information, including patient demographic information, such as race, it will give incorrect or inaccurate information, which can result in people ending up with less effective medications,” said Alemi.
Alemi and his co-researchers observed that when advising patients on options for treating depression. “AI systems could be biased against African Americans, recommending antidepressants that work for general, mostly White, patients but not for African Americans,” said Alemi.
The Details
Researchers looked at bias in an AI system meant to guide treatment for Major Depressive Disorder (MDD)—and whether race-blind models miss important signals for African American patients. The AI system used medical history—including whether a patient completed the full dose of the antidepressant—to recommend a medication. Researchers coded whether a patient discontinued the use of the antidepressant as a measure of AI-guided treatment failure or success.
The study underscores that race is not a biological determinant of depression or treatment response, emphasizing the social and environmental factors that affect depression. Some of these factors more common among African American patients may be poverty, low education, exposure to violence, discrimination, cultural stigma and negative attitudes toward mental health, and low access to mental health treatment resources.
“These data highlight the need to tailor antidepressants to fit the patient’s individual medical history. Clinicians do this, and, if done right, an AI system can help clinicians do so as well," said Cardenas.
“I hope that our approach will help inform AI in health care design and governance. This way we can truly pursue AI that improves the health of all,” said Cardenas.
The research team included Kevin Lybarger, assistant professor in the College of Engineering and Computing, along with master of science in health informatics graduates Cardenas, Maria Kurian, and Rachel Christine King; and Niloofar Ramezani from Virginia Commonwealth University.
Bias in AI-guided management of patients with major depressive disorders was published in the Journal of Health Equity in January 2026. The study was supported by the Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity . Research was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award .
Key Takeaways
AI systems for antidepressant guidance may be less effective for African American patients because models use data from general, primarily White, populations.
Race-specific models were more accurate in predicting African Americans’ responses to medications across all antidepressants studied.
Clinical AI treating mental health shouldn't rely solely on general population data when prescribing antidepressants for African Americans with depression.
Journal of Health Equity
Bias in AI-guided management of patients with major depressive disorders
5-Jan-2026