Abstract
Personalized medicine represents the dawn of a new era in clinical practice, education and research. Advances in immunology, genomics and pharmacogenomics enable precise diagnosis and targeted pharmacotherapies. Major depressive disorder and bipolar disorder are disorders of high prevalence worldwide. They pose a very high risk for suicide–especially bipolar disorder–and the number of patients receiving antidepressant treatment is increasing steadily. At the same time and in spite of the introduction of novel pharmacotherapies and non-pharmacologic interventions, the percentage of patients achieving full remission remains at about 35 percent.
A proinflammatory state is present in at least one subgroup of depressed and suicidal patients with elevated levels of C-reactive protein (CRP) and cytokines, especially IL-6 and IL-8. and a typical inflammatory signature profile. Based on understanding these processes, we seek to identify those at increased risk of depression and suicide. We currently repurpose used anti-inflammatory molecules as well as develop novel ones which specifically target neuroinflammatory components of suicide. Pharmacogenomics (PGx) is being accepted as an aid in choosing congruent medications and is an important player in the delivery of personalized psychiatric treatment. Results of the PREPARE study demonstrate greater response rates and cost effectiveness, thanks to PGx.
Angelos Halaris, M.D. is a board-certified psychiatrist, and Professor of Psychiatry at Loyola University Medical School. He is an active member of many national and international organizations. He has published over 200 refereed articles, numerous chapters, four books, and co-edited two monographs titled “Inflammation in Psychiatry” and “Neuroprogression in Psychiatric Disorders” with Dr. B. Leonard. He has given over 400 lectures at local, national and international forums and received several teaching awards. Dr. Halaris’ interests include affective and anxiety disorders, including major depressive and bipolar disorders, treatment resistance and general psychiatry. Currently his research focuses on biomarkers of inflammation in mood disorders and on pharmacogenomics. Dr. Halaris is a Lifetime Distinguished Fellow of the American Psychiatric Association as well as a former board examiner.
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