Please wait while the transcript is being prepared...
0:00
My name is Alessandro
Serretti and I am
a Professor of Psychiatry
at Kore University of Enna,
Italy, and that this
presentation will be
about pharmacogenetics
of antidepressants.
0:15
Why we need pharmacogenetics
or antidepressants?
Well, as a clinician,
I can tell you that it is
quite difficult to
treat patients with
depression because at present
we have to work in a recursive,
in a trial and error
procedure, because usually,
the first antidepressant that we
use is not useful for
all the patients.
Typically, one-third of
the patients respond
quite well to the first
antidepressant that we use,
but two-thirds
don't respond well.
Of this half are responding
to further treatments
and then we have one-third of
patients that are
non-responders,
the so called
treatment-resistant depression.
The other problem
and difficulty is
that the antidepressants
that we use in
our everyday clinical practice
are indeed quite as
slow in their action.
We need at least 2, 3,
sometime four weeks
or even more before
seeing the effect of
the treatment that we
are administering.
So it's clear also from
the slide that we are
starting from the first
antidepressant in
case of people with
depression that is being
treated for depression and
that can be chosen
a wide range of
antidepressants at present
in many markets worldwide,
we have more than
40 antidepressants.
Usually the clinician
chooses one that is
supposedly the best for the
patient and then waits,
or increases the
dose if needed to
see if the treatment
is tolerated or not,
and then it happens as I told
before that two-thirds of
patients indeed do not show
an adequate response to
the first treatment.
Therefore, for non-response
or poor tolerability,
we have to switch to a
second antidepressant.
Again, wait for 2, 3,
4 weeks until we
see the outcome.
Sometime it is needed
to change 2, 3,
4 antidepressants or make
combination or augmentations
or potentiations to achieve
a satisfactory result.
Of course, this is clear
that the current practice
from a clinical perspective
is far from ideal,
and this is exactly
the role of genetics,
so called pharmacogenetics
or antidepressants,
that is the final aim to predict
on the basis of the genetic
background of the subject,
which will be the best
treatment for every patient.
Instead of trying 1, 2, 3,
4 antidepressant and maybe
the fifth antidepressant is
the one that is effective.
