Personalized Medicine

Mental health is a leading cause of disability in the United States and Canada, with approximately one in four adults suffering from a diagnosable mental disorder each year1. Of the 27 million Americans currently taking antidepressants, more than half fail to achieve remission, and nearly 40% discontinue treatment within the first 30 days2,3,4,. Additionally, more than 10% of patients taking antidepressants experience significant adverse drug reactions5.

The data remains bleak for patients prescribed antipsychotic medications, with more than 50% of patients discontinuing antipsychotic medication within their first six months of treatment. A significant portion of antipsychotic treatment discontinuations result from serious drug side effects including rapid weight gain, tardive dyskinesia, diabetes, and sexual dysfunction6.

Most of these limiting outcomes are due to the lack of evidence-based genetic information available to clinicians about their patients to guide appropriate medication decisions. Dozens of psychiatric medications exist, each with a different mechanism of action and metabolic profile. Lack of specific patient information forces clinicians to follow standard protocols for prescribing psychiatric medications, despite the fact that there are substantial inter-patient genetic differences in both medication tolerance and response. Psychiatric medication protocols are based on outcome averages from large clinical trials. As a result, clinicians, not knowing how their specific patient will respond, must titrate drug dosages to achieve optimal blood levels. This process, frequently involving multiple drugs, may take months or years, at which point the chances of adverse side effects and insufficient response rates outweigh the prospects of full remission or substantial reduction of symptoms.

The concept of personalized medicine has rapidly gained momentum in the healthcare industry over the past decade. Personalized medicine refers to the tailoring of medical treatment to the individual characteristics of a patient. Using both genetic and specific patient non-genetic information, science can narrow down specific population groups that are more or less likely to respond to a medication and experience side effects.

This personalized approach to medicine already has become standard practice in many areas of healthcare including oncological and anticoagulant medication prescribing, where genetic testing is often required prior to prescription. Assurex Health is a pioneer in bringing personalized medicine to the field of psychiatry. Please view our Products area for more information about Assurex Health’s offerings.

More Information:

To learn more about mental illness and personalized medicine, please refer to the following links:

1 Kessler R.C, Chiu W.T, Demler O, Walters E.E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry, 62(6), 617-627.

2 Olfson M. et al. (2006). Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry163, 101-108.

3 Marcus S.C, & Olfson M. (2010). National trends in the treatment for depression from 1998 to 2007. Arch Gen Psychiatry67(12), 1265-1273.

4 Trivedi M.H. et al. (2006). Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry163, 28-40.

5 Machado M. et al. (2006). Remission, dropouts, and adverse drug reaction rates in major depressive disorder: a meta-analysis of head-to-head trials. Curr Med Res Opin22(9), 1825-1837.

6 Lieberman, J.A. et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. The New England Journal of Medicine, 353(12), 1209-1223.