engleski

The clinical application of pharmacogenetics : antidepressant drugs

There is substantial unexplained interindividual variability in treatment with antidepressants, as a proportion of patients given a regular dose do not respond properly or experience limiting side affects. Because of that the concept of individualized drug therapy on the basis of pharmacogenetics has become a major issue in psychopharmacology. The nature of drug response is highly complex involving genetic and environmental factors like age, gender, hepatic and renal status, nutrition, smoking and alcohol intake. Despite much effort, prediction of response is still hampered by many methodological problems and is not yet available for the clinical practice. However, a few of the results are now ready for translation into clinical practice. For exemplar, cytochrome P450 genotyping would be big step forward. Individualized drug treatment by genotyping cytochrome P450 could improve treatment, reduce side effects and increase drug compliance. The clinical application of pharmacogenetics requires integration of pharmacogenetic testing and interpretation. This review focuses primarily on recent knowledge and findings about cytochrome P450, p-glycoprotein (MDR1), serotonin transporter (SERT) and polymorphisms in neurotransmitter systems in the treatment with antidepressants. These findings are already relevant for clinicians or might become important in the near future.

pharmacogenetics; antidepressant drugs

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