New Vistas in the Management of Treatment-Refractory Psychiatric Disorders: Genomics and Personalized Medicine

To date, most therapies of treatment-refractory psychiatric disorders involve modifications of existing pharmacological treatments and/or cognitive therapies. However, many of these strategies are unable to bring these disorders into remission; therefore, a substantial number of patients with severe psychiatric disorders continue to have marked functional limitations. Newer therapies involve novel pharmacological approaches and novel psychotherapies as well as altering neuronal circuitry via techniques such as deep brain or transcranial magnetic stimulation; however, these newer therapies are also not completely efficacious. With the 10-year anniversary of the sequencing of the human genome, genetic analysis emerges as an important approach in assessing therapeutic response. In this review, the authors will examine the current knowledge of gene and environmental interactions in treatment response for a subset of psychiatric diseases.