Lecture – The Status of Laboratory Testing to Predict Antidepressant Response

Presented by Charles B. Nemeroff, MD, PhD, Dell Medical School at the University of Texas at Austin – Visiting Scholar Series lecture

“How good are we at treating depression?”

Nemeroff poses this question during his talk on the use of laboratory tests to predict response to antidepressant medication.

Watch now to learn more about:

• The challenges clinicians face in diagnosing individuals with depression and prescribing effective treatments
• The scientific principles that underlie genetic testing in medicine
• The status of genetic testing in predicting treatment response in psychiatry
• The future of personalized medicine in psychiatry

Nemeroff describes the many challenges facing clinicians in diagnosing patients and prescribing effective treatments. He points out that there is wide variation in the way individuals experience depression. Also, he reports that co-occurring conditions make diagnosis and treatment more complicated.

For these reasons, clinicians often take a “trial and error” approach with patients. As a result, treatments are not always effective.

Because of these issues, Nemeroff stresses the importance of predicting treatment response in patients with depression. He suggests that pharmacogenomics—studies into how a person’s genetic makeup affects the way they respond to therapeutic drugs—could hold the key to more accurate predictions.

An individual’s DNA, he says, is our “instruction manual.” Reading this manual and looking for “snips” in genetic code could lead to a better understanding of a patient’s mental health and show whether they will respond to specific antidepressants. This could lead to more individualized medicine, with treatments specifically tailored to a patient based on genetic information.

During the talk, Nemeroff discusses the status of current laboratory tests, including the ineffectiveness of current commercial pharmacogenetic tests. He details research into cytochrome P450 enzymes, which some believe can predict antidepressant side effects. He also presents findings from the GUIDED study, the largest randomized clinical trial of pharmacogenomic testing.

In his discussion, Nemeroff expresses optimism about the role pharmacogenomic testing can play in improving our understanding of antidepressant treatment response. He cautions, however, that commercially available pharmacogenomics tests to predict antidepressant efficacy and side effects are “not ready for prime time.” But he believes these tests will likely have a role in clinical practice in the future.