Abstract

A REVIEW ON POTENTIAL UTILITY OF PHARMACOGENETICS IN THE MANAGEMENT OF MAJOR DEPRESSIVE DISORDER

Sai Lakshmi Lahari N.*, Yamini Krishna K., Nithish V. and Thirumala Naik Dr. K.

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Abstract

Major depressive disorder (MDD) also detailed as depression, is one of the most typical and relentless psychiatric disorders globally concerned with loss of interest, low energy, persistent sadness, worse appetite and sleep patterns, suicidal thoughts and disturbance in daily physical and social activities. It was validated as fifth largest cause of years lived with disability (YLDs) in 2016 by the Global Burden of Diseases, Injuries, and Risk Factors study. The main objective is to review the variant genes that are responsible for the altered drug exposure in response to antidepressant (AD) and remission of symptoms in patients and also to analyse the application of pharmacogenetics (PGx) as a tool in clinical practice in treating MDD. A literature review was undertaken to summarize the published evidence through PubMed, WebMD and Medscape. All articles were identified from the data sources, clinical studies using PGx in the management of MDD, and articles containing other interesting aspects were included. In total, 82 full-text articles focusing on the PGx application in the management of MDD were reviewed and summarized. Most ADs are metabolized in the liver through the CYP450 enzyme system. Amongst the majorly replicated gene findings, cytochrome P450 genes primarily CYP2D6 and CYP2C19 are related to the altered drug exposure. By the utilization of PGx testing and GWAS, differences in the response to treatment by individuals due to genetic variation can be recognised. This helps in modification of treatment choice in individual patients therefore reduces the adverse events. Conclusion: This study helps in reviewing the utilization of PGx testing in treating MDD, thereby assisting in providing individualized treatment choice bringing about better clinical outcomes and safety issues in view of efficacy, tolerability and cost effectiveness with greater response to AD medications.

Keywords: Major depressive disorder, Pharmacogenetics, Antidepressant, PGx testing, GWAS.