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

Abbott, Ryan, Chang, Donald D., Eyre, Harris A., Bousman, Chad A., Merrill, David A. and Lavretsky, Helen (2017) Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life Depression?. The American Journal of Geriatric Psychiatry, 26 2: 125-133. doi:10.1016/j.jagp.2017.05.012


Author Abbott, Ryan
Chang, Donald D.
Eyre, Harris A.
Bousman, Chad A.
Merrill, David A.
Lavretsky, Helen
Title Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life Depression?
Journal name The American Journal of Geriatric Psychiatry   Check publisher's open access policy
ISSN 1545-7214
1064-7481
Publication date 2017-05-25
Year available 2017
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jagp.2017.05.012
Open Access Status Not yet assessed
Volume 26
Issue 2
Start page 125
End page 133
Total pages 9
Place of publication New York, NY United States
Publisher Elsevier
Language eng
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 15 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. In adult populations, newer generation DSTs show promise for the treatment of major depression. However, there are no primary clinical trials in LLD cohorts. Independent and comparative clinical trials are needed.
Keyword Depression
decision support tool
genetic testing
geriatric
late-life depression
pharmacogenomic
precision medicine
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID K24 AT009198
K24 MH086481
R01 AT008383
R01 MH097892
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
Faculty of Medicine
School of Medicine Publications
 
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Created: Wed, 14 Feb 2018, 11:02:30 EST