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There has been a proliferation of laboratory tests that purport to improve treatment outcome. The promise of personalized medicine is that a laboratory test will help the clinician choose the right medication for the right patient. Currently, prescribing in psychiatry involves the clinician making an educated guess about which medication might be most useful for the patient on the basis of the presenting symptoms, concurrent medications, comorbid conditions, and the pharmacological profile of the drug, including the known side effects. Psychiatrists lack the equivalent of the culture and sensitivity (so-called C&S) tests that the infectious disease specialist can employ to match an antibiotic to a specific bacterium. Similarly, we do not have genetic tests, such as those available to the oncologist, that characterize the genetic profile of a tumor so that the most effective medication can be chosen (e.g., HER2 sensitivity in breast cancer).
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