Gerretsen Philip, Müller Daniel J, Tiwari Arun, Mamo David, Pollock Bruce G
Centre for Addiction and Mental Health, University of Toronto, Canada.
Dialogues Clin Neurosci. 2009;11(4):363-76. doi: 10.31887/DCNS.2009.11.4/pgerretsen.
We currently rely on large randomized controlled trials and meta-analyses to make clinical decisions; this places us at a risk of discarding subgroup or individually specific treatment options owing to their failure to prove efficacious across entire populations. There is a new era emerging in personalized medicine that will focus on individual differences that are not evident phenomenologically. Much research is directed towards identifying genes, endophenotypes, and biomarkers of disease that will facilitate diagnosis and predict treatment outcome. We are at the threshold of being able to predict treatment response, primarily through genetics and neuroimaging. In this review we discuss the most promising markers of treatment response and adverse effects emerging from the areas of pharmacogenetics and neuroimaging in depression and schizophrenia.
目前，我们依靠大型随机对照试验和荟萃分析来做出临床决策；这使我们面临丢弃亚组或个体特异性治疗方案的风险，因为这些方案未能在整个人群中证明有效。个性化医疗的新时代正在兴起，它将关注那些在现象学上不明显的个体差异。许多研究致力于识别疾病的基因、内表型和生物标志物，以促进诊断并预测治疗结果。我们即将能够主要通过遗传学和神经影像学来预测治疗反应。在这篇综述中，我们讨论了抑郁症和精神分裂症领域中药物遗传学和神经影像学所出现的最有前景的治疗反应和不良反应标志物。
