Pharmacogenomic and pharmacometabolomic biomarkers of the efficacy and safety of antidepressants: focus on selective serotonin reuptake inhibitors

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The efficacy and safety of psychopharmacotherapy with antidepressants is of great medical importance. The search for clinical and biological predictors for choosing the optimal psychopharmacotherapy with antidepressants is actively underway all over the world. Research is mainly devoted to searching for associations of polymorphic gene variants with the efficacy and safety of therapy. However, information about a patient’s genetic polymorphism is often insufficient to predict the efficacy and safety of a drug. Modern research on the personalization of pharmacotherapy should include, in addition to genetic, phenotypic biomarkers. This is important because genotyping, for example, cannot accurately predict the actual metabolic activity of an isoenzyme. To personalize therapy, a combination of methods is required to obtain the most complete profile of the efficacy and safety of the drug. Successful treatment of depression remains a challenge, and inter-individual differences in response to antidepressants are common. About half of patients with depressive disorders do not respond to the first attempt at antidepressant therapy. Serious side-effects of antidepressant pharmacotherapy and discontinuation of treatment due to their intolerance are associated with ineffective therapy. This review presents the results of the latest studies of «omics» biomarkers of the efficacy and safety of antidepressants.

Keywords:

antidepressants

pharmacogenomics

pharmacometabolomics

selective serotonin reuptake inhibitors

Authors:

Gareeva A.E.

Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences;
Kemerovo State University;
Russian Medical Academy of Continuing Professional Education

ORCID: 0000-0003-0254-3917

Borodina L.S.

Republican Narcological Dispensary No. 1

ORCID: 0000-0001-5116-0790

Pozdnyakov S.A.

Moscow Scientific and Practical Center for Narcology of the Moscow Health Department

ORCID: 0000-0002-5198-6637

Timerbulatov I.F.

Russian Medical Academy of Continuing Professional Education;
Usoltsev Central Clinical Psychiatric Hospital;
Russian University of Medicine

ORCID: 0000-0001-5241-6073

Received:

22.01.2024

Accepted:

14.02.2024

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