Pharmacogenetic decision support tools: a new paradigm for late-life depression?

dc.contributor.authorAbbott, R.
dc.contributor.authorChang, D.
dc.contributor.authorEyre, H.
dc.contributor.authorBousman, C.
dc.contributor.authorMerrill, D.
dc.contributor.authorLavretsky, H.
dc.date.issued2018
dc.description.abstractClinicians 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.
dc.description.statementofresponsibilityRyan Abbott, Donald D. Chang, Harris A. Eyre, Chad A. Bousman, David A. Merrill, Helen Lavretsky
dc.identifier.citationAmerican Journal of Geriatric Psychiatry, 2018; 26(2):125-133
dc.identifier.doi10.1016/j.jagp.2017.05.012
dc.identifier.issn1064-7481
dc.identifier.issn1545-7214
dc.identifier.urihttp://hdl.handle.net/2440/112101
dc.language.isoen
dc.publisherElsevier
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1127700
dc.source.urihttp://dx.doi.org/10.1016/j.jagp.2017.05.012
dc.subjectDepression
dc.subjectdecision support tool
dc.subjectgenetic testing
dc.subjectgeriatric
dc.subjectlate-life depression
dc.subjectpharmacogenomic
dc.subjectprecision medicine
dc.titlePharmacogenetic decision support tools: a new paradigm for late-life depression?
dc.typeJournal article
pubs.publication-statusPublished

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