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通过药物基因组学优化抗抑郁治疗:一例报告

Optimization of antidepressant treatment by pharmacogenomics: a case report.

作者信息

Zhang Ying, Yue Weihua

机构信息

Tianjin Anding Hospital, Tianjin Municipal Mental Health Center, Tianjin, 300222, China.

Institute of Mental Health, Peking University Sixth Hospital, Beijing, 100191, China.

出版信息

BMC Psychiatry. 2025 Jan 10;25(1):34. doi: 10.1186/s12888-025-06481-4.

Abstract

BACKGROUND

Few new psychiatric drugs have entered the market in recent decades; in contrast, the number of drugs carrying pharmacogenomic labels continues to increase. For the foreseeable future, the advancement of psychiatry and drug therapy may hinge on personalized treatment. Currently, antipsychotic or antidepressant choices rely heavily on the clinical experience of psychiatrists and potentially lengthy iterative trials. During these trials, the clinical response to treatment in acutely depressed patients can be assessed only after several weeks of exposure to the drug. Although pharmacogenomic testing has been used in clinical care for several years, most Chinese clinicians struggle to utilize the information accurately, resulting in expensive tests that provide little real benefit to patients. Here, we demonstrate how to combine the results of pharmacogenomic testing to develop an individualized treatment plan. Our goal is to find the optimal medication regimen and dosage for the patient in the shortest possible time, control symptoms as soon as possible, and predict adverse drug reactions. This approach aims to offer a practical therapeutic idea for clinical practice.

CASE PRESENTATION

We present the case of a 27-year-old female patient experiencing a relapse of depression. Despite previous attempts with empiric medication, her symptoms remained uncontrolled, leading to exacerbation and drug withdrawal reactions. Utilizing the results of pharmacogenetic testing, we crafted an individualized treatment plan, resulting in rapid remission without any adverse drug reactions.

CONCLUSION

Recognizing the complexity of antidepressant response, our patients aim to improve their understanding, as well as that of other healthcare providers, by undergoing pharmacogenomics testing. This enhances the credibility of their medication choices. While pharmacogenomics is just one aspect considered in selecting a treatment regimen for depression, it remains a valuable tool for increasing credibility and mitigating potential adverse events.

摘要

背景

近几十年来,几乎没有新的精神科药物进入市场;相比之下,带有药物基因组学标签的药物数量却在持续增加。在可预见的未来,精神病学和药物治疗的进展可能取决于个性化治疗。目前,抗精神病药或抗抑郁药的选择在很大程度上依赖于精神科医生的临床经验以及可能漫长的反复试验。在这些试验中,急性抑郁患者对治疗的临床反应只能在接触药物几周后才能评估。尽管药物基因组学检测已在临床护理中应用数年,但大多数中国临床医生仍难以准确利用这些信息,导致检测费用高昂,却对患者几乎没有实际益处。在此,我们展示如何结合药物基因组学检测结果来制定个体化治疗方案。我们的目标是在尽可能短的时间内为患者找到最佳用药方案和剂量,尽快控制症状,并预测药物不良反应。这种方法旨在为临床实践提供一种切实可行的治疗思路。

病例介绍

我们呈现一位27岁女性抑郁症复发患者的病例。尽管此前尝试过经验性用药,但其症状仍未得到控制,导致病情加重和药物戒断反应。利用药物遗传学检测结果,我们制定了个体化治疗方案,患者迅速康复且未出现任何药物不良反应。

结论

认识到抗抑郁反应的复杂性,我们的患者旨在通过进行药物基因组学检测来增进自身以及其他医疗服务提供者的理解。这增强了他们用药选择的可信度。虽然药物基因组学只是选择抑郁症治疗方案时考虑的一个方面,但它仍然是提高可信度和减轻潜在不良事件的宝贵工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f877/11720597/35146f45473d/12888_2025_6481_Fig1_HTML.jpg

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