Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, Baltimore, MD 21205, USA.
Psychiatr Clin North Am. 2010 Mar;33(1):181-224. doi: 10.1016/j.psc.2009.12.001.
Existing psychotropic medications for the treatment of mental illnesses, including antidepressants, mood stabilizers, and antipsychotics, are clinically suboptimal. They are effective in only a subset of patients or produce partial responses, and they are often associated with debilitating side effects that discourage adherence. There is growing enthusiasm in the promise of pharmacogenetics to personalize the use of these treatments to maximize their efficacy and tolerability; however, there is still a long way to go before this promise becomes a reality. This article reviews the progress that has been made in research toward understanding how genetic factors influence psychotropic drug responses and the challenges that lie ahead in translating the research findings into clinical practices that yield tangible benefits for patients with mental illnesses.
现有的精神疾病治疗药物，包括抗抑郁药、情绪稳定剂和抗精神病药，在临床上并不理想。它们只对一部分患者有效或产生部分反应，而且常常伴有使人衰弱的副作用，导致患者不遵医嘱。人们对药物遗传学有望实现这些治疗方法的个体化应用以最大限度地提高疗效和耐受性寄予厚望；然而，在这一期望成为现实之前，还有很长的路要走。本文综述了在研究遗传因素如何影响精神药物反应方面所取得的进展，以及在将研究结果转化为能给精神疾病患者带来切实益处的临床实践方面所面临的挑战。
