A one-size-fits-all approach to mental health treatment does not exist – it never has, and it most likely never will. Humans are undeniably complex, both psychologically and physiologically, so it makes sense that we require different regimens in life – in the therapies that work, the wellness strategies we use, and certainly the medications we take to manage and treat medical conditions.
Enter precision medicine. Fueled and publicized widely by the National Institutes of Health (NIH) and endorsed by President Obama and White House Initiatives, precision medicine is the practice of prevention and disease treatment that targets a person based on individual variables such as genes, human environment and lifestyle. As more research is being conducted about the genes that lead to various mental health conditions and substance use disorders, precision medicine serves as a response to translating that research into something actionable in treating patients appropriately.
Unfortunately, shame and stigma often cause a lag in response in the mental health field in a variety of ways. Exciting research is underway at places like Mayo Clinic, with a robust biobank for psychiatry, and at Stanford University, with a medical center focused on using precision medicine to treat underserved populations. Though there are research initiatives in flight, societally, the stigma and umbrella belief “one size fits all” is perpetuated for mental health patients, a view that often leads to patients wondering why their medications aren’t working for them, and many abandoning them altogether.
Jeffrey Lieberman, M.D., the Lawrence C. Kolb Professor and chair of Psychiatry at Columbia University, states that precision medicine “offers the possibility of ‘peeling the onion’: dissecting psychiatric disorders into much more precise categories that pertain to that individual.” Through “mapping a patient’s progression,” patients can be grouped based on genes and targeted with the appropriate medication based on genetic correlations – based on fact, not trial and error.
It has been said that precision medicine will help physicians select the “right drug, for the right patient, at the right time, every time.” Within the mental health realm, this is critically important. Many patients who are on psychotropic medications – antidepressants, anti-anxiety medications, mood stabilizers, etc. – often find the right dosage and type of medication based on trial and error. Since psychotropic medications alter a person’s mood, when the wrong medication is prescribed, it can severely impact a patient’s life. Some individuals have the patience to wait and try new medications; others abandon their medications in the midst of a flawed and strenuous process due to the stress, mood fluctuations and decreased quality of life.