Pharmacogenetic studies of antidepressant response: how far from the clinic?
Because the US FDA has begun to focus on disclosure of pharmacogenetic testing results in applications for new drug approval and review of existing drugs (see, eg, http://www.fda.gov/OHRMS/DOCKETS/AC/05/slides/2005-4194S1_Slide-Index.htm), the application of such testing in a clinical setting is likely to increase substantially. Instead of small cohorts of patients, potentially nearly every participant in the large pivotal trials required for drug approval could help inform the future application of that drug. Psychiatry as a whole, and antidepressant prescribing ni particular, stands to benefit in the near term from the identification of newer treatment targets that may overcome some of the limitations of current therapeutics. On the other hand, despite the excitement about the rapid pace of development in psychiatric pharmacogenetics, a number of key issues remain to be addressed before these discoveries are applied in a clinical setting. Close coordination will be required between those who study treatment efficacy and effectiveness and those who study genetic variation in populations to ensure that studies yield results that have scientific importance and clinical importance as well.
Perlis
Roy H
RH
Pharmacogenetics Research Unit, Depression and Bipolar Clinical and Research Programs, Center for Human Genetics Research, Massachusetts General Hospital, 15 Parkman St., WACC 812, Boston, MA 02114, USA. rperlis@partners.org
D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics*; D006801:Humans; D012701:Serotonin / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014365:Tryptophan Hydroxylase / Q000235:genetics / Q000378:metabolism
D019389:Cytochrome P-450 CYP2D6; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D014365:Tryptophan Hydroxylase; C494784:TPH2 protein, human