[Prediction and Personalized Medicine of Antidepressant Treatment in Japanese MDD Patient].

Masaki Kato
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Abstract

Various classes of antidepressants have been used in the treatment of major depressive disorder (MDD) ; however, treatment efficacy is inadequate, as 30-40% of patients do not expe- rience response even after sufficiently long treatment period with adequate dose of antidepressant. For the treatment-resistant patient to the therapy based on the generalized evidence, is it possible to provide an appropriate and improved treatment based on personalized medicine, taking into account predictable candidates such as sub-symptoms of depression and genetic factors instead? There is only little evidence for this in Japanese MDD, and consequently we use the evidence of Caucasians as reference, however, could we use the evidence of the popu- lation whose genetical, social, and cultural background are very different from Japanese popu- lation? In this review, I will refer to our randomized controlled studies that have some predict- able candidates including genetic factors designed for personalized medicine in MDD patients, and present an overview of procedures for making predictions of current treatment and pro- ceeding towards personalized medicine.

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[日本重度抑郁症患者抗抑郁药物治疗预测及个体化用药]。
各种类型的抗抑郁药已用于治疗重度抑郁症(MDD);然而,治疗效果不足,因为30-40%的患者即使在足够长的治疗期和足够剂量的抗抑郁药后也没有出现反应。对于基于广义证据的治疗抵抗患者,是否有可能提供基于个性化医学的适当和改进的治疗,考虑到可预测的候选因素,如抑郁症的亚症状和遗传因素?在日本的重度抑郁症中,这方面的证据很少,因此我们使用了白种人的证据作为参考,然而,我们是否可以使用遗传、社会和文化背景与日本人口非常不同的人群的证据呢?在这篇综述中,我将参考我们的随机对照研究,这些研究有一些可预测的候选者,包括为重度抑郁症患者个性化医疗设计的遗传因素,并概述了预测当前治疗和推进个性化医疗的程序。
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