4.8 Review

Pharmacogenomics: A road ahead for precision medicine in psychiatry

Journal

NEURON
Volume 109, Issue 24, Pages 3914-3929

Publisher

CELL PRESS
DOI: 10.1016/j.neuron.2021.09.011

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Funding

  1. Academy of Medical Sciences Springboardaward [SBF005\1083]
  2. Cardiff University: European Union's Seventh Framework Programme [279227]
  3. Medical Research Council Centre [MR/L010305/1, G0800509, MR/L011794/1, MC-PC-17212]

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Psychiatric genomics sheds light on psychiatric conditions and may lead to new drug targets, while psychiatric pharmacogenomics research has the potential to bring about rapid changes in clinical practice. However, challenges such as a lack of replication studies, inconsistencies in defining treatment outcomes, and insufficient investment in longitudinal data collections have hindered progress in this field.
Psychiatric genomics is providing insights into the nature of psychiatric conditions that in time should identify new drug targets and improve patient care. Less attention has been paid to psychiatric pharmacogenomics research, despite its potential to deliver more rapid change in clinical practice and patient outcomes. The pharmacogenomics of treatment response encapsulates both pharmacokinetic (what the body does to a drug) and pharmacodynamic (what the drug does to the body) effects. Despite early optimism and substantial research in both these areas, they have to date made little impact on clinical management in psychiatry. A number of bottlenecks have hampered progress, including a lack of large-scale replication studies, inconsistencies in defining valid treatment outcomes across experiments, a failure to routinely incorporate adverse drug reactions and serum metabolite monitoring in study designs, and inadequate investment in the longitudinal data collections required to demonstrate clinical utility. Nonetheless, advances in genomics and health informatics present distinct opportunities for psychiatric pharmacogenomics to enter a new and productive phase of research discovery and translation.

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