Tools for optimising pharmacotherapy in psychiatry (therapeutic drug monitoring, molecular brain imaging and pharmacogenetic tests): focus on antidepressants.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_6FD14CC75A02
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Tools for optimising pharmacotherapy in psychiatry (therapeutic drug monitoring, molecular brain imaging and pharmacogenetic tests): focus on antidepressants.
Journal
The world journal of biological psychiatry
Author(s)
Eap C.B., Gründer G., Baumann P., Ansermot N., Conca A., Corruble E., Crettol S., Dahl M.L., de Leon J., Greiner C., Howes O., Kim E., Lanzenberger R., Meyer J.H., Moessner R., Mulder H., Müller D.J., Reis M., Riederer P., Ruhe H.G., Spigset O., Spina E., Stegman B., Steimer W., Stingl J., Suzen S., Uchida H., Unterecker S., Vandenberghe F., Hiemke C.
ISSN
1814-1412 (Electronic)
ISSN-L
1562-2975
Publication state
Published
Issued date
10/2021
Peer-reviewed
Oui
Volume
22
Number
8
Pages
561-628
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Objectives: More than 40 drugs are available to treat affective disorders. Individual selection of the optimal drug and dose is required to attain the highest possible efficacy and acceptable tolerability for every patient.Methods: This review, which includes more than 500 articles selected by 30 experts, combines relevant knowledge on studies investigating the pharmacokinetics, pharmacodynamics and pharmacogenetics of 33 antidepressant drugs and of 4 drugs approved for augmentation in cases of insufficient response to antidepressant monotherapy. Such studies typically measure drug concentrations in blood (i.e. therapeutic drug monitoring) and genotype relevant genetic polymorphisms of enzymes, transporters or receptors involved in drug metabolism or mechanism of action. Imaging studies, primarily positron emission tomography that relates drug concentrations in blood and radioligand binding, are considered to quantify target structure occupancy by the antidepressant drugs in vivo. Results: Evidence is given that in vivo imaging, therapeutic drug monitoring and genotyping and/or phenotyping of drug metabolising enzymes should be an integral part in the development of any new antidepressant drug.Conclusions: To guide antidepressant drug therapy in everyday practice, there are multiple indications such as uncertain adherence, polypharmacy, nonresponse and/or adverse reactions under therapeutically recommended doses, where therapeutic drug monitoring and cytochrome P450 genotyping and/or phenotyping should be applied as valid tools of precision medicine.
Keywords
Antidepressants, brain imaging, pharmacogenetics, precision medicine, therapeutic drug monitoring
Pubmed
Web of science
Open Access
Yes
Create date
19/05/2021 15:12
Last modification date
23/10/2021 6:38
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