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New review of pharmacogenomics in psychiatry published by world-leading neuroscience journal

6 October 2021

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Researchers in the MRC Centre for Neuropsychiatric Genetics and Genomics (MRC CNGG) at Cardiff University have published a comprehensive review of pharmacogenomics in psychiatry in one of the most influential and well-regarded neuroscience journals.

The article, written by Dr. Antonio Pardiñas, Professor Mike Owen and Professor James Walters, has been published today in the journal Neuron.

This review of pharmacogenomics, the study of the role of the genome in drug response, concluded that, if researchers can seize the opportunities offered by new technologies, there are strong grounds for believing that this will lead to improved clinical practice and patient outcomes.

Professor Owen said:

Pharmacogenomics has huge potential to help us understand why people respond differently to drugs used in clinical practice, and to guide clinicians in identifying the best drug for individual patients.
Professor Sir Michael Owen Professor, Division of Psychological Medicine and Clinical Neurosciences; Emeritus Director of the Neuroscience and Mental Health Research Institute

Solutions identified included large studies employing routine electronic health records, the use of consistent and well-defined measures of drug and treatment response, incorporating adverse drug reactions and measures of serum metabolites as part of predictive models, and increasingly involving currently underrepresented populations.

Professor Walters added, “Psychiatric medications play an important part in many people’s recovery from mental illness, but they are not effective in everyone and can commonly lead to adverse effects.

“In this paper we review how pharmacogenomics can help explain people’s different responses to medications and assess its clinical potential to help with prescribing the right medication at the right dose.”

On average treatments in psychiatry only lead to sustained improvements about 50% of the time, largely due to a combination of adverse effects leading to discontinuation of treatment and lack of efficacy.

Individuals vary greatly in their response to specific drugs and matching the right drug to the right patient often entails a process of trial and error. Numerous studies have tried to find ways of matching the right drug to the right patient, a framework called “precision medicine”. However, many factors can influence individual differences in drug response and liability to adverse effects, including genetic variation.

Dr. Pardiñas said, “Many research studies have been carried out in psychiatric drugs and conditions since the 1990s, but few findings are withstanding the tests of time and scientific replication.”

The review compares this situation to the “challenges” faced by medical genomics research a decade ago, which this field navigated through increased efforts in large-scale collaborative studies and the development of robust experimental methodologies.

Professor Owen added, “We have reviewed the field of psychiatric pharmacogenomics and identified several challenges that need to be overcome to allow us to delineate groups of individuals who could benefit from particular drugs, and which might also help with the design of new drugs.”

Read the full paper: Pharmacogenomics: A road ahead for precision medicine in psychiatry

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