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Joint Research Seminar (23 Nov 2015)

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Joint Research Seminar

Centre for Genomic Sciences
State Key Laboratory of Brain and Cognitive Sciences
Department of Psychiatry

Is Pharmacogenetic Testing Ready
for the Psychiatry Clinic?

Dr James L Kennedy

Director, Molecular Brain Science, CAMH
Head of Neurogenetics Section, CAMH
Head, Tanenbaum Centre for Pharmacogenetics
Co-Director, Division of Brain and Therapeutics, Dept. of Psychiatry, and
Professor, Department of Psychiatry and Institute of Medical Science, University of Toronto
Fellow, Royal Society of Canada


23 November 2015 (Mon)
10:00 – 11:00 am


Seminar Room 7
Laboratory Block, Faculty of Medicine Building

21 Sassoon Road, Pokfulam, HK

 
Abstract:

In genomics the amount of information available is increasing rapidly. At the same time our knowledge of inter-individual differences in terms of response and side effects to medications is at an early stage. For example, an important dilemma facing psychiatrists when they need to select an antipsychotic medication for their patient is the forced choice between risk for weight gain and diabetes with the newer generation drugs versus the risk of tardive dyskinesia and other motor side effects with first generation antipsychotics. We have developed a model of seven genes (melanocortin-4 receptor, serotonin 2C, neuropeptide Y, others) that predicts 67% of the variance in risk for this weight gain (Tiwari et al, 2015). In terms of antidepressant treatment there are now several replicated studies showing a significant benefit of gene guided medication selection over treatment as usual (Altar et al, 2015). Genes tested include CYP450, 5HT2A, and 5HTTLPR. In addition to significant clinical improvement and reduction of side effects there is also a documented reduction in health care costs when genetic guidance is used in antidepressant treatment. Regarding the concern that physicians will not be able to efficiently translate complex genetic information into clinical decision-making, we have surveyed over 200 psychiatrists and family practitioners in our Toronto-based pharmacogenetics study (www.IM-PACT.ca; n=4,200 patients tested) and found that the overwhelming majority of physicians found our user-friendly genetic report to be readily understandable, and over 90% believe that pharmacogenetics testing will become standard of care in the future. We are now working on defining variations in allele frequencies in medication related genes across human ancestral groups, particularly Asians and Africans. Furthermore there are relevant epigenetic changes in the cortisol system genes, and in the serotonin transporter gene, that may affect medication response and side effects.

About the Speaker:

Dr Kennedy has training in three major areas: neuroscience, clinical psychiatry, and molecular genetics. His main research interest over the past 20 years has been the identification of susceptibility genes for psychiatric disorders. His discoveries include: 1) the role of the DRD4 gene in ADHD, 2) the DRD3 gene predicting risk for Tardive Dyskinesia, 3) the 5HTTLPR genetic marker predicts risk for antidepressant induced mania, and several genes that predict antipsychotic response. Major current projects led by Dr Kennedy include the IMPACT study examining a large sample (N=20,000) of patients to discover new pharmacogenetic markers, and determine the usefulness and cost-benefit of genetic testing applied to choice and dosage of psychiatric medications in clinical care. Furthermore, he is leading a large randomized controlled clinical trial of pharmacogenomic tests in 1,200 depression and schizophrenia patients, funded by Genome Canada. He has published pioneering findings relating gene variants in the dopamine, serotonin, and neurodevelopment systems to psychiatric disorders, neuroimaging (PET and MRI) and to treatment response. Dr Kennedy has published more than 600 scientific articles with over 20,000 citations, and he is an active lecturer at numerous international conferences.

 

ALL ARE WELCOME

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