- With Mayo Clinic psychiatrist
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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April 15, 2011
Treatment resistant depression focus of gene research
By David Mrazek, M.D.
In recent blog entries, we've discussed research that's linked gene variations with medications in order to determine if they'll be safe and effective for individuals with depression.
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The study of these relationships is referred to as psychiatric pharmacogenomics. These aren't tests to determine whether someone is depressed or not. As some of you pointed out, after years of suffering, the diagnosis of depression is not the issue.
The important new development is trying to find an effective treatment. While single genes such as the serotonin transporter gene provide us with some clues, there are still other genes that need to be discovered in order to be able to make better predictions than we can today.
In the past year, three large studies have been conducted to explore possible new genes associated with a better outcome. They include a study in England that found a gene called interleukin-2 was associated with a response to Celexa. However, studies in Germany and the United States didn't confirm this finding.
At Mayo Clinic, we're conducting a similar study to try to identify more gene variants so that we can make better predictions of response to treatment. Another goal is to find new genes that are associated with adverse effects. While many adverse effects are associated with antidepressant medications, one of the most serious is "activating" an episode of mania in someone who's previously not experienced mania.
Another major concern is that sometimes antidepressant medication seems to aggravate suicidal thoughts. Progress is being made in using genomic testing to be able to identify who may be more likely to develop these problems.
One of the greatest motivations for finding new genes associated with medication response is that gene variation may give us new clues to help us develop new medications for depression — given that at least one in five of you with depression don't respond to any of the drugs currently available.
Helping you if you have treatment resistant depression is a critically important priority for research. Please share your thoughts.
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