TAILIEUCHUNG - Pharmacogenomics: The Promise of Personalized Medicine for CNS Disorders

Few published data are available on the financial costs of TM in low- and middle-income countries. The data presented here on the use of traditional healers are extracted from the World Bank’s living standards surveys in Vietnam to provide one nationally representative snapshot of the situation. Of 28,254 individuals in the sample, 10,033 had consulted a health care provider in the four weeks preceding the survey. These consultations included both home visits and visits to a provider. Of the 10,033, 1,829 had been to a public provider, 1,431 to a private provider, 7,650 to a pharmacy, and 259 to a traditional healer. 1 The most common reasons for visiting a traditional provider were. | REVIEW Neuropsychopharmacology REVIEWS 2009 34 159-172 2009 Nature Publishing Group All rights reserved 0893-133X 09 159 Pharmacogenomics The Promise of Personalized Medicine for CNS Disorders Jose de Leon 1 2 3 4 1Mental Health Research Center Eastern State Hospital University of Kentucky Lexington KY USA 2College of Medicine University of Kentucky Lexington KY USA 3College of Pharmacy University of Kentucky Lexington KY USA 4Psychiatry and Neurosciences Research Group CTS-549 Institute of Neurosciences Medical School University of Granada Granada Spain This review focuses first on the concept of pharmacogenomics and its related concepts biomarkers and personalized prescription . Next the first generation of five DNA pharmacogenomic tests used in the clinical practice of psychiatry is briefly reviewed. Then the possible involvement of these pharmacogenomic tests in the exploration of early clinical proof of mechanism is described by using two of the tests and one example from the pharmaceutical industry iloperidone clinical trials . The initial attempts to use other microarray tests measuring RNA expression as peripheral biomarkers for CNS disorders are briefly described. Then the challenge of taking pharmacogenomic tests compared to drugs into clinical practice is explained by focusing on regulatory oversight the methodological scientific issues concerning diagnostic tests and cost-effectiveness issues. Current information on medicine-based evidence and cost-effectiveness usually focuses on average patients and not the outliers who are most likely to benefit from personalized prescription. Finally future research directions are suggested. The future of personalized prescription in psychiatry requires consideration of pharmacogenomic testing and environmental and personal variables that influence pharmacokinetic and pharmacodynamic drug response for each individual drug used by each patient. Neuropsychopharmacology Reviews .

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