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Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life Depression?

Abbott, Ryan, Chang, DD, Eyre, HA, Bousman, CA, Merrill, D and Lavretsky, H (2017) Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life Depression? American Journal of Geriatric Psychiatry.

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Abstract

Clinicians still employ a “trial-and-error” approach to optimizing treatment regimens for late-life depression (LLD). With LLD affecting a significant and growing segment of the population, and with only about half of older adults responsive to antidepressant therapy, there is an urgent need for a better treatment paradigm. Pharmacogenetic decision support tools (DSTs), which are emerging technologies that aim to provide clinically actionable information based on a patient’s genetic profile, offer a promising solution. Dozens of DSTs have entered the market in the past fifteen years, but with varying level of empirical evidence to support their value. In this clinical review, we provide a critical analysis of the peer-reviewed literature on DSTs for major depression management. We then discuss clinical considerations for the use of these tools in treating LLD, including issues related to test interpretation, timing, and patient perspectives. There are no primary clinical trials in LLD cohorts. However, in adult populations, newer generation DSTs show promise for the treatment of major depression. Further independent and head-to-head clinical trials are required to further validate this field.

Item Type: Article
Divisions : Faculty of Arts and Social Sciences > School of Law
Authors :
NameEmailORCID
Abbott, Ryanr.abbott@surrey.ac.ukUNSPECIFIED
Chang, DDUNSPECIFIEDUNSPECIFIED
Eyre, HAUNSPECIFIEDUNSPECIFIED
Bousman, CAUNSPECIFIEDUNSPECIFIED
Merrill, DUNSPECIFIEDUNSPECIFIED
Lavretsky, HUNSPECIFIEDUNSPECIFIED
Date : 25 May 2017
Identification Number : 10.1016/j.jagp.2017.05.012
Copyright Disclaimer : © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords : depression; geriatric; pharmacogenomic; decision support tool; genetic testing; late-life depression; precision medicine
Depositing User : Melanie Hughes
Date Deposited : 25 May 2017 08:54
Last Modified : 22 Sep 2017 08:22
URI: http://epubs.surrey.ac.uk/id/eprint/841155

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