Lin Keh-Ming, Perlis Roy H, Wan Yu-Jui Yvonne
Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Taipei, Taiwan.
Dialogues Clin Neurosci. 2008;10(4):401-8. doi: 10.31887/DCNS.2008.10.4/kmlin.
Despite remarkable progress, pharmacotherapy in general, including that for the treatment of depressive conditions, has often ignored the magnitude and clinical significance of the huge interindividual variations in pharmacokinetics and pharmacodynamics, resulting in poor compliance, suboptimal therapeutic effects, and treatment resistance. Advances in pharmacogenomics and computer modeling technologies hold promise for achieving the goals of "individualized" ("personalized") medicine. However, the challenges for realizing such goals remain substantial. These include the packaging and interpretation of genotyping results, changes in medical practice (innovation diffusion), and infrastructural, financing, ethical, and organizational issues related to the use of new information.
尽管取得了显著进展,但一般药物治疗,包括治疗抑郁状况的药物治疗,常常忽视了药代动力学和药效学中个体间巨大差异的程度及临床意义,导致依从性差、治疗效果欠佳和治疗抵抗。药物基因组学和计算机建模技术的进展有望实现“个体化”(“个性化”)医学的目标。然而,实现这些目标仍面临诸多重大挑战。这些挑战包括基因分型结果的整理和解读、医疗实践的变革(创新传播)以及与新信息使用相关的基础设施、资金、伦理和组织问题。