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Pharmacogenomics and Biomarkers of Depression

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Antidepressants

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 250))

Abstract

The standard of care for antidepressant treatment in major depressive disorder (MDD) is a trial-and-error approach. Patients often have to undergo multiple medication trials for weeks to months before finding an effective treatment. Clinical factors such as severity of baseline symptoms and the presence of specific individual (anhedonia or insomnia) or cluster (atypical, melancholic, or anxious) of symptoms are commonly used without any evidence of their utility in selecting among currently available antidepressants. Genomic and proteomic biomarker have gained recent attention for their potential in informing antidepressant medication selection. In this report, we have reviewed some of the major pharmacogenomics studies along with individual genetic and proteomic biomarker of antidepressant response. Additionally, we have reviewed the blood-based protein biomarkers that can inform selection of one antidepressant over another. Among all currently available biomarkers, C-reactive protein (CRP) appears to be the most promising and pragmatic choice. Low CRP (<1 mg/L) in patients with MDD predicts better response to escitalopram while higher levels are associated with better response to noradrenergic/dopaminergic antidepressants. Future studies are needed to demonstrate the superiority of a CRP-based treatment assignment over high-quality measurement-based care in real-world clinical practices.

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Authors and Affiliations

  1. University of Texas Southwestern, Dallas, TX, USA

    Manish K. Jha & Madhukar H. Trivedi

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  1. Manish K. Jha
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  2. Madhukar H. Trivedi
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Correspondence to Manish K. Jha .

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  1. School of Medicine-Wichita, University of Kansas, Wichita, KS, USA

    Matthew Macaluso

  2. School of Medicine-Wichita, University of Kansas, Wichita, KS, USA

    Sheldon H. Preskorn

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Jha, M.K., Trivedi, M.H. (2018). Pharmacogenomics and Biomarkers of Depression. In: Macaluso, M., Preskorn, S. (eds) Antidepressants. Handbook of Experimental Pharmacology, vol 250. Springer, Cham. https://doi.org/10.1007/164_2018_171

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