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David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Feb. 5, 2011
Gene research offers hope for treating depression
By David Mrazek, M.D.
Pharmacogenomics is a new field of study in medicine. It involves the identification of genetic variations that predict the response of a patient to a medication. Pharmacogenomics is relevant for all types of drugs such as medications for asthma or hypertension. It's now possible to use pharmacogenomic testing to help select an antidepressant.
In a previous blog, I discussed the relationship between a variant of the serotonin transporter gene and vulnerability to developing depression when faced with severe stress. If you have the more active form of this gene, you're less likely to develop depression even if you find yourself in a stressful situation. However, if you have the more active form of this gene and do become depressed, you're more likely to get better if you take a selective serotonin reuptake inhibitor (SSRI) antidepressant like Prozac (fluoxetine), Paxil (paroxetine), or Celexa (citalopram).
The probability of a good response to an SSRI is particularly high if you identify yourself as being "white." This suggests that other gene variations that are more common in patients of European ancestry may also influence the response of these patients to SSRI's.
For several years, it's been known that patients with the more active form of the serotonin transporter gene are more likely to respond to SSRI treatment. However, it's only been possible to test patients to see whether they have a more or less active form of this gene for the past three years. Based on the results of this pharmacogenomic testing, a psychiatrist is now able to develop a better understanding of what the probability will be for a specific patient achieving a good clinical outcome. The primary goal of testing is simply to be able to avoid side effects and identify an effective antidepressant medication more quickly.
To be able to get an even more accurate prediction of response, it will ultimately be necessary to test more than any one single gene as many genes influence the probability of responding to treatment. As testing becomes more sophisticated, there's every reason to believe that treatment outcomes will continue to improve. For many of you struggling with depression, the fact that there are now many researchers working to better understand antidepressant medication response should provide some hope.
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