Implications of pharmacogenomics in depression pathophysiology and treatment

Pharmacogenetic decision-support tools offer a novel approach to the targeted treatment of major depression. Research indicates that genetic factors play a significant role in major depression pathophysiology and impact significantly antidepressant efficacy and tolerability. Only half of patients respond to antidepressants and only one third will remit following an initial antidepressant trial. To improve response and remission rates and reduce adverse effects, pharmacogenetic decision-support tools have been developed to identify genetic variants that impact the pharmacokinetics and pharmacodynamics of antidepressants to allow the most appropriate choice of treatment and dose. Based on emerging evidence, pharmacogenetic decision-support tools present a promising opportunity to more effectively treat depression and reduce the growing burden of disease of depression at a population level. However, further research is required to validate these tools and better understand the genetic risk factors for major depression. This, in turn, will allow optimization of the clinical utility of pharmacogenetic tools.