Personalized Medicine in the field of Psychiatry

PERSONALIZED MEDINCE IN THE FIELD OF PSYCHIATRY

ADVANCES , UPDATES AND FUTURE

Recent advances in genetic technologies and the completion of the Human Genome Project has generated a plethora of information that is essential to the understanding of specific aspects of human biology and medicine Alongside the goal of sequencing the entire human genome and identifying genes associated to every disease , there has been a tremendous drive to design and maximize technologies that would have a profound impact on drug discovery , development and therapy within the pharmaceutical industry . Automated instrumentation such as

the DNA microarray system has enabled economic high-throughput DNA sequencing and gene mapping for genomic research . Such revolutionary genomic techniques have also determined that there are specific variations in genetic markers within the genome . These polymorphisms are distributed throughout the human genome , and there is an estimated 10 million single nucleotide polymorphisms (SNPs ) existing in the human genome . Such minute differences may confer inconsistencies in individual drug responses to particular drugs . In this light , there have been strong proposals for individualized genetic testing to improve drug therapy , efficacy and safety

The field of pharmacogenomics or toxicogenomics is a recent revolutionary area in biomedicine which merges the genomic information generated from DNA analysis and the pathophysiology of preventive medicine . Once an individual 's genetic pro in terms of disease risk and drug response is determined , a personalized approach to treatment and therapy may be designed . It is a novel field where the norm one drug fits all ' is circumvented . The concept is based on therapy with the right drug at the right dose in the right patient (Mancinelli et al . 2000 . The approach involves classification of patients according to their phenotypic disease pro into discrete subcategories , which are , in turn , defined by genetic variations associated with the disease or drug response , or both . One advantage to this type of approach is that drug therapy in genetically defined populations can be more effective and more importantly - less toxic than broad-range target populations

Approximately ten years ago , the application of genetically-defined drug therapy to psychiatry was weak . It was then observed that interindividual differences in the genetic makeup dramatically alter the ability of inherent enzymes to deactivate pharmacological agents , which then lead to prolonged anesthetic effects (Kalow , 1997 . Other notable observations include differences in clearance time for certain drugs or modification of certain antidepressants to active metabolites leading to a drug overdose , or a reduced capacity of a patient to reach plasma level of therapeutic range . Hence , in psychiatry alone , the one-to-one relation of genotype to phenotype ratio may not be followed . The employment of pharmacogenetics in psychiatry involves two aspects . One involves the use of drug-responsiveness as a tool for a better understanding of complex genetic traits , and the other aspect concerns the role of genetic variation to individualized pharmacological therapy

In psychiatry , the identification of genes associated with schizophrenia , autism , bipolar affective dis , Tourette 's syndrome has been a major focus for several decades . After years of research investigation , genetic...