title: Predicting response to psychopharmacological treatment: survey of recent results.
abstract: BACKGROUND
  Treatment with antidepressants and antipsychotics, though effective, is unspecific as agents that differ greatly in their biochemical and pharmacological actions have virtually the same efficacy. Half of the patients with initial improvement show incomplete response, while a large proportion of patients exhibit a refractory clinical picture which is resistant to all treatment modalities.
  
  
  METHODS
  Our analyses were based on a reference study of 2,848 depressive inpatients under monotherapeutic treatment with 7 different antidepressants or placebo, along with a naturalistic study of depressive and schizophrenic patients (296 inpatients, 363 outpatients) under today's "standard" polypharmaceutic treatment regimens.
  
  
  RESULTS
  The empirical data suggested the following predictors of response: (1) severity at baseline, (2) early onset of improvement, (3) unwanted side-effects, and (4) medical comorbidity. A combination of these predictors with Therapeutic Drug Monitoring (TDM) methods has direct clinical relevance.
  
  
  CONCLUSIONS
  Evidence-based approaches to personalized treatment help improving the unsatisfactory situation patients and clinicians are faced with, given today's incomplete treatments and the fact that the mechanisms by which antidepressants and antipsychotics ultimately exert their therapeutic effects are only marginally understood.
authors.affiliation: Psychiatric University Hospital Zurich, Research Group Psychiatric Genetics, Zurich, Switzerland. k454910@bli.uzh.ch
authors.forename: H
authors.initials: H
authors.lastname: Stassen
authors.forename: I-G
authors.initials: IG
authors.lastname: Anghelescu
authors.forename: J
authors.initials: J
authors.lastname: Angst
authors.forename: H
authors.initials: H
authors.lastname: Böker
authors.forename: K
authors.initials: K
authors.lastname: Lötscher
authors.forename: D
authors.initials: D
authors.lastname: Rujescu
authors.forename: A
authors.initials: A
authors.lastname: Szegedi
authors.forename: C
authors.initials: C
authors.lastname: Scharfetter
mesh_terms: D000367:Age Factors; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism; D018450:Disease Progression; D016903:Drug Monitoring; D006801:Humans; D007075:Immunoglobulin M / Q000235:genetics; D019338:Polypharmacy; D011600:Psychopharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D007075:Immunoglobulin M