精神病学中的药物基因组学:从亚洲角度的实践建议 (2024)
Shih Ee Goh1, Saumya Shekhar Jamuar2,3, Siew Eng Chua4
1Institute of Mental Health, Singapore.
Annals of the Academy of Medicine, Singapore
|January 3, 2025
概括
精神病学中的药基因组测试不是标准实践. 将测试限制在具有强有力的证据的特定药物基因对上,如抗抑郁药和CYP2C19/CYP2D6,用于指导药物治疗. 由于没有确的证据,不建议直接向消费者提供专家小组.
科学领域:
- 精神病学药物基因组学
- 遗传学在心理健康治疗中的作用
- 个性化医疗在精神病学中的个人化医疗.
背景情况:
- 药物基因组测试正在精神病学中出现,用于药物指导.
- 直接面向消费者的小组面临采用障碍:可变的证据,成本效益和监管障碍.
- 需要针对亚洲人口提出建议.
研究的目的:
- 审查精神病学药物基因组学的最新更新.
- 为亚洲人群提供上下文化摘要和建议.
- 在精神病学实践中指导医疗保健专业人员.
主要方法:
- 对精神病学中药物基因组学的文献综述,重点关注亚洲人群.
- 建议分级的应用 评估,开发和评估证据对决策框架的应用.
- 与来自公共和私营部门的精神病医生举行共识会议.
主要成果:
- 药物基因组测试应侧重于已有证据的药物基因对 (例如抗抑郁药和CYP2C19/CYP2D6).
- 在新加坡,由于临床结果数据不确定,不建议直接向消费者提供面板.
- 目前的证据不支持精神病学实践中的常规药物基因组测试.
结论:
- 药基因组测试不建议作为标准精神病学实践.
- 例外情况包括对药物度或严重药物不良反应的担忧.
- 鼓励对药物基因关联,临床和成本效益进行进一步的研究.
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