Prediction of response to drug therapy in psychiatric disorders

Open Biol. 2018 May;8(5):180031. doi: 10.1098/rsob.180031.

Abstract

Personalized medicine has become increasingly relevant to many medical fields, promising more efficient drug therapies and earlier intervention. The development of personalized medicine is coupled with the identification of biomarkers and classification algorithms that help predict the responses of different patients to different drugs. In the last 10 years, the Food and Drug Administration (FDA) has approved several genetically pre-screened drugs labelled as pharmacogenomics in the fields of oncology, pulmonary medicine, gastroenterology, haematology, neurology, rheumatology and even psychiatry. Clinicians have long cautioned that what may appear to be similar patient-reported symptoms may actually arise from different biological causes. With growing populations being diagnosed with different psychiatric conditions, it is critical for scientists and clinicians to develop precision medication tailored to individual conditions. Genome-wide association studies have highlighted the complicated nature of psychiatric disorders such as schizophrenia, bipolar disorder, major depression and autism spectrum disorder. Following these studies, association studies are needed to look for genomic markers of responsiveness to available drugs of individual patients within the population of a specific disorder. In addition to GWAS, the advent of new technologies such as brain imaging, cell reprogramming, sequencing and gene editing has given us the opportunity to look for more biomarkers that characterize a therapeutic response to a drug and to use all these biomarkers for determining treatment options. In this review, we discuss studies that were performed to find biomarkers of responsiveness to different available drugs for four brain disorders: bipolar disorder, schizophrenia, major depression and autism spectrum disorder. We provide recommendations for using an integrated method that will use available techniques for a better prediction of the most suitable drug.

Keywords: autism spectrum disorder; bipolar disorder; classification; major depression; prediction; schizophrenia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Autism Spectrum Disorder / drug therapy
  • Autism Spectrum Disorder / genetics
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / genetics
  • Clinical Trials as Topic
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / genetics
  • Genetic Markers*
  • Humans
  • Mental Disorders / drug therapy*
  • Mental Disorders / genetics
  • Pharmacogenetics
  • Pharmacogenomic Variants*
  • Precision Medicine
  • Schizophrenia / drug therapy
  • Schizophrenia / genetics

Substances

  • Antipsychotic Agents
  • Genetic Markers