Genetics of Depression: In Pursuit of Perfect Treatment

There is a complicated nexus between genes, environment and drug response. Studies in genetic variability would help to understand drug response in the mentally ill who are drug-resistant.

Depression affects an estimated 121 million people worldwide. A person is described as being clinically depressed when his sadness stretches for weeks, even months, and affects his daily activities. To many sufferers life comes to a stand- still.

An American survey has revealed that more than 16 percent of Americans will experience major depressive disorders during their lifetime.

Depression - Types, Causes, Symptoms, Diagnosis, Treatment
Depression is one of the most common mental disorders affecting approximately 340 million people in the world. No one is immune from depression - it occurs in people of all social classes, all countries and all cultural settings.

There are several stigmas linked to depression, but studies have revealed that it is a medical illness just like diabetes or a heart condition. This condition does not merely affect the mind but makes an impact on the entire being of a person.

Untreated depression often leads to suicide but the good news is that depression is treatable. The majority of individuals who receive treatment go on to make full recovery.

The individualized treatment approach has revolutionalized treatment for depression by optimizing the effectiveness of the treatment and by reducing side effects.

Bipolar Disorder-Causes-Risk Factors-Types-Symptoms-Treatment-Complications-FAQs
Bipolar Disorder is a brain disorder in which people show “mood swings”. Changes in the level of neurotransmitters in brain, and psychosocial factors are thought to be involved.

Genetic factors play an important role in a person’s response to drugs and in the side effects that he suffers; however one study has found that environmental factors have a greater role to play!

It has been understood that there is a complicated nexus between genes, environment and drug response. It is hoped that studies in genetic variability would help to understand a person’s response to medications for mental illness, particularly in those who are drug-resistant.

Quiz on Depression
The World Health Organization reports that depression is one of the main causes of disability affecting about 121 million people worldwide. More tragically, it claims around 850,000 lives every year. Hence, it is important that we understand this affliction to help ourselves or our loved ones to cope and, hopefully, resolve it. How well do you know the facts about depression? Take this quiz and find out.

The term “pharmacogenetics” has been used to describe the mechanism by which gene variation influences drug response and the rate of side effects.

Detecting specific “candidate” genes would allow the therapists to predict the manner in which an individual metabolizes a medicine. This in turn would enable doctors to choose the correct therapy that is most suitable for that patient, thereby, helping to reduce side effects.

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STAR*D, is the largest prospective study of unipolar depression which enhanced pharmacogenetic knowledge about antidepressant response and tolerability. Various markers were explored in this study that could influence treatment modality of this illness and it was found that a combination of genes, rather than a single gene, can act as markers, or predictors, of response to anti-depressants.

In January 2005, the FDA approved the Roche AmpliChip CYP450 genotyping test for variants in the gene CYP2D6 and CYP2C19, using the patients DNA derived from buccal or blood samples. The test helps therapists to determine appropriate treatment plans, including dosing, for medications metabolized by CYP2D6 or CYP2C19. It analyzes the patient’s DNA to predict if he or she –

·        has more difficulty reaching therapeutic concentrations;

·        responds normal medicine metabolizing capacity

·        experiences more adverse effects;

·        is a poor metabolizer and at higher risk for overdose.

Although genetic testing may influence treatment choices, current data is not adequate enough to be conclusive. However, with further research the dream of personalized therapy is soon likely to become a reality!

Reference: Pharmacogenetics and Depression: Realized Dream or Great Expectation?; Jolene et al; US Pharm. 2011;36(11):72-76.

Source-Medindia