A Precision Medicine Approach to the Treatment of Psychiatric Disorders

Due to a lack of clarity about the pathophysiology of psychiatric disorders, short and long-term treatment outcomes continue to be very inconsistent, and the prescribing of multiple medications that can have unpredictable, conflicting, and sometimes paradoxical effects continues to be more the rule than the exception in modern psychiatric practice. Dosing is also an issue, as standard doses of psychotropic drugs are often too high, thus causing some patients to incur unnecessary side effects, which in turn can lead to poor compliance or even discontinuation of treatment. Worse yet, these negative outcomes can cause disappointed patients to dissuade other would-be patients from seeking treatment. Recognizing these concerns and the fact that most persons with mental illness never seek treatment to begin with, the need for greater precision and fewer side effects in the prescribing of psychotropic drugs cannot be overstated. Based on an emerging hypothesis on the pathophysiology of psychiatric disorders, this article will discuss a promising new approach to psychopharmacotherapy that has the potential to simplify drug selection, reduce dosing requirements, and minimize side effects. By targeting the core physiological abnormality in psychiatric disorders, the use of medications that have unpredictable, conflicting, and sometimes paradoxical effects can be minimized, and the lowest doses of the most appropriate drugs can be used to achieve faster, more consistent, and more enduring therapeutic effects in a group of disorders that are now considered to be a public health crisis.