Pharmacogenomics

Abstract

Pharmacogenomics is a rapidly growing field dedicated to identifying genetic markers that will allow practitioners to identify safe and effective therapy that is tailored to the individual patient. As a result, pharmacogenomic testing has the potential to optimize drug therapy for a variety of disease states. The landmark Sequenced Treatment Alternatives to Relieve Depression trial, commonly known as the STAR*D trial, showed that only a disappointing 30 % of patients experience remission from depression symptoms with their initial trial of antidepressant therapy. Furthermore, other studies have shown that 70 % of patients not remitting after their first medication trial may endure symptoms for months before experiencing relief secondary to drug therapy. In the future it is hoped that advancing pharmacogenomics research will help identify the safest and most effective medication for each patient-not only for the treatment of depression but for other disease states as well. Currently pharmacogenomic testing is not widely implemented; however, this is likely to change as clinicians become increasingly familiar with this field. This chapter will familiarize clinicians with the field of pharmacogenomics by (1) building a simple understanding of how genetic variability can alter drug response, (2) discussing current approaches in pharmacogenomics research, (3) describing helpful resources for practitioners, (4) providing an overview of the clinical application of pharmacogenomics and the associated issue of reimbursement, and (5) reviewing opinions on the future of pharmacogenomics in the clinical setting.