A Systematic Review to Determine if Family History of Response to Medication Predicts Outcome in Mood Disorders

Examining a patient's family history of medication response is a commonly used method to inform treatment selection. Though widely recommended, there are no published reviews that assess the validity of this approach when treating patients with affective disorders.

All published studies in the form of case-control or randomized controlled trials that enrolled probands with either bipolar I or II depression or major depression and were written in English were included. Studies must have also included biological relatives and must have included at least 2 families. The authors compared the methodology of each trial to a hierarchy of study designs best suited to demonstrate the predictive ability of a family history of response to a medication.

All studies involved only a small number of participants and none of the publications included in this review used a study design that reached the highest level of study quality needed to prove the link between 2 family members' likelihood of response to a medicine. Two studies had some elements of a level I study while the remaining studies were classified at level II or III of the study hierarchy.

Although small studies suggest that a family history of drug response can predict outcome in mood disorder patients, the designs of these studies do not confirm this in a definitive manner.