No abstract

ClinicalTrials.gov identifier: NCT01507155.

Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized treatment plans with the highest likelihood of success. Recently, many studies have been published demonstrating improved patient outcomes and decreased healthcare costs for psychiatric patients who utilize genetic testing. This review will describe evidence supporting the clinical utility of genetic testing in psychiatry, present several case studies to demonstrate use in everyday practice, and explore current patient and clinician opinions of genetic testing.

Recovery of motor function after serious injury to motor cortex during childhood is a dramatic example of the plasticity of the child's brain to injury. In addition, we suggest that the behavioral disorder that emerged in this patient may be related to limbic system injury suffered during the shunt revision.

Psychiatric disorders are a leading cause of disability worldwide and despite significant pharmacologic advances, often remain difficult to diagnose correctly and treat fully. Factors which contribute to these difficulties include imprecise understanding of etiology, syndromal nature of many disorders and overlap in diagnostic criteria between conditions, medical and psychiatric comorbidity and high rates of noncompliance to treatment either due to lack of efficacy or adverse effects. In addition to genetics and known biological factors, the severity and presentation of many psychiatric conditions may be influenced by psychosocial factors, which in turn can affect treatment outcomes. Currently, the selection of medications for a given patient in psychiatry is primarily based on a trial and error process; thus, there is an urgent need to identify biomarkers that can improve diagnostic homogeneity and provide useful prognostic information. Pharmacogenetics has the potential, in combination with other approaches, to enhance both care at an individual level as well as in drug development by improving efficacy and minimizing drug-induced side effects.