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Review outlines future of precision medicine in psychiatry

An evidence review recently published in Mayo Clinic Proceedings highlighted the benefits of using precision medicine in prescribing antidepressants.

“In January 2015, President Barack Obama introduced the Precision Medicine Initiative with a mandate to promote more accurate diagnosis and personalized management of health and disease. Today, antidepressants are one of the most commonly prescribed medication classes in the United States, and there is increasing interest in individualizing treatment selection for more than 20 FDA-approved treatments for major depressive disorder,” Malik Nassan, MBBS, of the Mayo Clinic Depression Center, Rochester, Minnesota, and colleagues wrote.

Greater precision in pharmacotherapeutic recommendations for individuals could potentially reduce adverse effects and increase response rates and overall efficacy, according to Nassan and colleagues.

To explore feasibility and efficacy of precision medicine within psychiatry, researchers reviewed evidence that contributed to the implementation of pharmacokinetic pharmacogenetic guidelines for antidepressants primarily metabolized by cytochrome P450 2D6 (CYP2D6) and cytochrome P450 2C19 (CYP2C19).

“With the continuous decrease in the cost of genetic testing, the willingness of insurance companies to cover such tests, and the increase in published data providing more robust evidence of clinical importance, CYP2D6/CYP2C19 genotyping might become, in the near future, a routine test before prescribing relevant antidepressants to all patients,” the researchers write. “Meanwhile, utilizing the current available evidence and trying to follow the most supported guidelines must be our provisional goal for more precise medical practice in psychiatry.” – by Amanda Oldt

Disclosure: Nassan reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.