Abstract
Approximately 50% of Alzheimer's disease (AD) patients develop psychotic symptoms, leading to a subtype known as psychosis in AD (AD + P), which is associated with accelerated cognitive decline compared to AD without psychosis. Currently, no FDA-approved medication specifically addresses AD + P. This study aims to improve psychosis predictions and identify potential therapeutic agents using the DeepBiomarker deep learning model by incorporating drug-target interactions. Electronic health records from the University of Pittsburgh Medical Center were analyzed to predict psychosis within three months of AD diagnosis. AD + P patients were classified as those with either a formal psychosis diagnosis or antipsychotic prescriptions post-AD diagnosis. Two approaches were employed as follows: (1) a drug-focused method using individual medications and (2) a target-focused method pooling medications by shared targets. The updated DeepBiomarker model achieved an area under the receiver operating curve (AUROC) above 0.90 for psychosis prediction. A drug-focused analysis identified gabapentin, amlodipine, levothyroxine, and others as potentially beneficial. A target-focused analysis highlighted significant proteins, including integrins, calcium channels, and tyrosine hydroxylase, confirming several medications linked to these targets. Integrating drug-target information into predictive models improves the identification of medications for AD + P risk reduction, offering a promising strategy for therapeutic development.