[How Far is "Personalized Medicine" for Depression from Clinical Use?].

Masaki Kato
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Abstract

Major depressive disorder is a debilitating disease that imposes significant social and eco- nomic burdens due to its 10% life-time prevalence and 15% association with suicide, and so urgent measures are needed. However, not all individuals benefit from antidepressant treat- ment, and some patients poorly respond or develop side effects. It would be helpful to identify a biomarker that could indicate the best therapeutic tool that is likely to be effective and toler- able for each patient In this context, a marked effort has been directed toward the search for genetic predictors of drug efficacy in mood disorders over the last few years. However, the present evidence from pharmacogenomic studies does not match those expectations. So, how far is "personalized medicine" for depression from clinical use? It is important to translate the results of such pharmacogenomic studies to better treatment in clinical practice. Here, I pro- vide an overview of pharmacogenomic research results with both a genome-wide approach and candidate approach, and suggest possible ways to apply pharmacogenomic results in clini- cal settings.

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[抑郁症的“个性化医疗”离临床应用还有多远?]
重度抑郁症是一种使人衰弱的疾病,由于其10%的终生患病率和15%的自杀相关性,造成了重大的社会和经济负担,因此需要采取紧急措施。然而,并非所有人都能从抗抑郁治疗中获益,一些患者反应不佳或产生副作用。在这种背景下,在过去的几年里,人们一直在努力寻找情绪障碍药物疗效的遗传预测因子,这将有助于确定一种生物标志物,它可以指示对每个患者可能有效和可接受的最佳治疗工具。然而,目前来自药物基因组学研究的证据并不符合这些期望。那么,治疗抑郁症的“个体化药物”离临床应用还有多远呢?将这些药物基因组学研究的结果转化为临床实践中更好的治疗是很重要的。在这里,我提供了药物基因组学研究结果的概述,包括全基因组方法和候选方法,并提出了在临床环境中应用药物基因组学结果的可能方法。
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