Antidepressant prescribing in the precision medicine era: a prescriber’s primer on pharmacogenetic tools

BMC Psychiatry

Review

Malcolm Forbes¹  Mahesh Jayaram¹  Malcolm Hopwood¹  Chee Ng¹  Harris Eyre²  Chad A. Bousman³  Michael Berk⁴  Charles F. Reynolds⁵ 

[1] Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, 161 Barry Street, Level 3, 3053, Parkville, VIC, Australia;Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, 161 Barry Street, Level 3, 3053, Parkville, VIC, Australia;Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia;Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia;Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, 161 Barry Street, Level 3, 3053, Parkville, VIC, Australia;Department of General Practice, The University of Melbourne, Parkville, VIC, Australia;Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne, VIC, Australia;Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia;Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, 161 Barry Street, Level 3, 3053, Parkville, VIC, Australia;Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia;Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia;University of Pittsburgh School of Medicine, Pittsburgh, USA;

关键词: Precision medicine;    Pharmacogenomics;    Major depressive disorder;    Psychiatry;    Decision support;   

DOI  :  10.1186/s12888-017-1230-5

 received in 2016-11-23, accepted in 2017-02-04,  发布年份 2017

来源: Springer

【 摘 要 】

About half of people who take antidepressants do not respond and many experience adverse effects. These detrimental outcomes are in part a result of the impact of an individual’s genetic profile on pharmacokinetics and pharmcodynamics. If known and made available to clinicians, this could improve decision-making and antidepressant therapy outcomes. This has spurred the development of numerous pharmacogenetic-based decision support tools. In this article, we provide an overview of pharmacogenetic decision support tools, with particular focus on tools relevant to antidepressants. We briefly describe the evolution and current state of antidepressant pharmacogenetic decision support tools in clinical practice, followed by the evidence-base for their use. Finally, we present a series of considerations for clinicians contemplating use of these tools and discuss the future of antidepressant pharmacogenetic decision support tools.

【 授权许可】

CC BY   
© The Author(s). 2017