Pharmacogenomic and Pharmacometabolomic Biomarkers of the Efficacy and Safety of Antidepressants: Focus on Selective Serotonin Reuptake Inhibitors

The efficacy and safety of psychopharmacotherapy with antidepressants is of great medical importance. The search for clinical and biological predictors for the selection of optimal psychopharmacotherapy with antidepressants is under active investigation throughout the world. Most studies address the search for associations between polymorphic variants of genes and the efficacy and safety of therapy. However, data on patients’ genetic polymorphisms are often insufficient for predicting the efficacy and safety of a drug. Contemporary research on the personalization of pharmacotherapy should include not only genetic, but also phenotypic biomarkers. This is important because genotyping, for example, cannot accurately predict the real metabolic activity of an isoenzyme. Successful treatment of depression remains a complex task; between-individual differences in responses to antidepressants are common. About half of patients with depressive disorders do not respond to the first attempt at antidepressant therapy. Serious side effects in pharmacotherapy with antidepressants and discontinuation of treatment due to intolerance are associated with lack of therapeutic efficacy. This review presents results from the latest studies of “omics” biomarkers of the efficacy and safety of antidepressants.