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Lifelong Learning: Clinical Implementation of Phar ...
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Clinical implementation of pharmacogenetic decision support tools for prescribing antidepressant drugs is discussed. Currently, there is insufficient evidence to support their widespread use, but they may be informative in predicting side effects. Factors limiting the development of a standardized pharmacotherapeutic approach for major depression include heterogeneous depression endophenotypes, lack of reliable biomarkers, and individual differences in drug metabolism. Combinatorial pharmacogenetic decision support tools use algorithms to integrate genetic variants, but there are limitations in study design and methodological weaknesses in clinical trials evaluating their effectiveness. Further research is needed to determine their clinical utility and cost-effectiveness. These tools can improve medication adherence, reduce adverse drug events, and save costs, but evidence supporting genetic markers and pharmacogenetic predictors varies. CYP450 genotyping is the most well-established marker. Further research is needed to determine the clinical utility and cost-effectiveness of these tools, ideally considering both pharmacokinetic and pharmacodynamic factors and supported by rigorous clinical trials.
Keywords
pharmacogenetic decision support tools
predicting side effects
heterogeneous depression endophenotypes
reliable biomarkers
individual differences in drug metabolism
combinatorial pharmacogenetic decision support tools
genetic variants
clinical trials
medication adherence
CYP450 genotyping
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