The Role of Pharmacogenomics to Guide Treatment in Mood and Anxiety Disorders

Abstract

Interest has grown in genetic testing to personalize treatment approaches in psychiatry, especially mood disorders and to a lesser extent anxiety. However, numerous studies of genetic variants of metabolizing enzymes, along with fewer studies of single nucleotide polymorphisms of drug transporter proteins, receptors, and other putative drug targets such as neurotransmitter reuptake pumps and receptors, have reported contradictory findings that have not translated into practical, costeffective treatment recommendations. In this article, we review basic principles of genetic testing and highlight selected elements of genetic testing in cancer. We then critically review the current status of genetic research in pharmacokinetics and pharmacodynamics, as well as the few clinical trials that have been performed. After discussing the limited clinical applications of current research, we make recommendations for developing more clinically useful studies of cost-effective approaches to genetic testing in the treatment of mood and anxiety disorders.

Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis.

“…This is accompanied by a minimum of five symptoms affecting behavior (disturbed sleep, changes in appetite or weight, fatigue, slowed movement) and/or cognition (feelings of guilt, worthlessness, thoughts of death, difficulty in concentration or indecisiveness; American Psychiatric Association, 2013). Typically, MDD is considered an episodic disorder consisting of one or more depressive episodes; an episode is defined by a minimum 2-week period, accompanied by five of the above-described symptoms, with a distinct onset and offset (Dubovsky & Dubovsky, 2002). MDD is one of the most prevalent of all mental disorders with an estimated 13.5% to 21.2% of the population experiencing at least one episode of depression (Kessler & Walters, 1998).…”