FEB 23, 2017 7:30 AM PST

KEYNOTE: Towards a new era of precision medicine in psychiatry: Using genetic algorithms to optimize medication outcome

Speaker
  • Head of the Pharmacogenetics Research Clinic at the Campbell Family Mental Health Research Institute at CAMH, and Associate Professor in the Department of Psychiatry at the University of Toro
    Biography
      Dr. Mueller earned his MD at the University of Bonn (Germany) and completed his residency training in Psychiatry at the Charité University Clinic in Berlin. In 2008, he has been appointed at the University of Toronto (Department of Psychiatry), and as Clinician Scientist at CAMH. At the same time, he became Head of the Pharmacogenetics Research Clinic at CAMH which is one of the first of its kind worldwide to develop clinical implementation strategies (e.g., Müller DJ et al., 2013; PMID:24151801). Dr. Mueller's overall research goals are to investigate genetic causes of response and side effects to psychiatric medications. This line of research aims to significantly improve treatment of psychiatric conditions and to lessen the burden of medication side effects and to avoid negative drug-drug interactions. In addition, he is actively involved in developing pharmacogenetic guidelines for physicians and patients and is affiliated with the Clinical Pharmacogenetics Implementation Consortium (Caudle et al., 2014; PMID: 24479687). For more information, visit www.pharmacogenetics.ca For a complete publication record, see:
      https://scholar.google.de/citations?user=lnbto4AAAAAJ&hl=de

    Abstract

    Psychiatric disorders are among the leading causes of disability worldwide. One fifth of the population will suffer from a psychiatric disorder in their lifetime. Antipsychotic and antidepressant drugs remain the cornerstone of treatment in schizophrenia and mood disorders. However, more than 50% of patients do not respond well to their initial treatment and much time is often spent until the right medication is found for the right patient.  In addition, some develop serious side-effects that cause them to discontinue the medication. Thus, predictive tools would be of enormous help to optimize and personalize medication treatment.

    Genomics offer a tremendous opportunity to personalize medication treatment by use of preemptive genotyping selected genes known to be involved in drug metabolism, neurotransmission and occurrence of side effects. Over the past decade, evidence has emerged that assessing gene variants for drug metabolizing enzymes such CYP2D6 or CYP2C19   can be used to improve treatment with antidepressant and antipsychotics. In addition, various gene variants have been identified involved in psychotropic medication induced side effects such ads for carbamazepine-induced Steven-Johnsons Syndrome or antipsychotic-induced weight gain.

    The presentation will review current recommendations provided by expert panels such as the Clinical Pharmacogenomics Implementation Consortium (CPIC) and regulatory agencies (e.g., FDA). Data from our own research studies in Toronto including more than 7,000 patients will be presented showing acceptance and benefits of genetic testing in clinical practice. In addition, implementation strategies and cost-benefits will be reviewed, and commercially available test kits will be critically discussed.    

     

    Learning Objective 1:  Understanding principles of how genetics influences response and side effects in psychopharmacology      

     

    Learning Objective 2:  Application of pharmacogenetics in clinical practice 


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