Genetics and antidepressant: Where we are

Nowadays antidepressants are still administrated by a trial and error principle and a substantial proportion of patients does not benefit from treatment or suffers from significant side effects. Clinical features failed to predict the antidepressant response and tolerability, so pharmacogenetic seems to be the most promising way to achieve the target of an individualized therapy. The aim of this paper is to review the current knowledge of findings in pharmacogenetic of antidepressant, and to analyze how they could impact the everyday clinical practice. We mainly focused on pharmacodynamics associated genes where promising results have been found, although still poor replicated to allow clinical applications. On the other hand evidences regarding pharmacokinetics genes, although consistent enough to allow the design of genetic chips, seem to have less relevance to predict antidepressant response. The main results are underlined, new promising polymorphisms are suggested. Finally, the clinical impact of pharmacogenetic studies is debated.