Novel Molecular Targets for Mood Disorders and Psychosis Proceedings of a Workshop (2021) / Chapter Skim
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8 Potential Next Steps and Future Opportunities
8 Potential Next Steps and Future Opportunities
Pages 55-60
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From page 55... ...
. • A systems perspective could help answer unresolved questions regarding treatment refractoriness to enable the identification of new targets and to help design polytherapeutic, precision medicine approaches (Haas, Meltzer-Brody)
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From page 56... ...
. • Comorbidity, unclear taxonomies, reduced specificity across diagnostic categories, and increased molecular complexity pose challenges to the development of precision medicine approaches for psychiatric disorders (Simon)
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From page 57... ...
For example, he posited that psychiatric disorders may represent dysrhythmias of brain neurocircuits and may require novel treatment approaches similar to the way cardiac arrhythmias are treated with multiple drugs, procedures, and devices. Taking a Systems Perspective One poorly understood aspect of psychiatric disorders is treatment refractoriness, said Samantha Meltzer-Brody, who spoke about the clinical effects of brexanolone in PPD patients in Chapter 4.
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From page 58... ...
A systems perspective such as the one Haas envisions could enable the identification of novel molecular targets, then use that information to inform rational approaches to poly therapies that could integrate drug treatments with device and digital solutions. Multidisciplinary approaches to therapeutic development for mental health conditions that go beyond a sole focus on neurons may also fuel progress, said Stuart Hoffman, senior health science officer for traumatic brain injury (TBI)
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From page 59... ...
To achieve this, he said, will require collaboration with patients in the collection of large datasets that enable establishing outcomes and safety. Greg Simon, an investigator at Kaiser Permanente Washington Health Research Institute and psychiatrist in Kaiser Permanente's Behavioral Health Service, argued that the push in psychiatry for greater precision and more refined therapeutic targets has been stymied by increasing diffusion across the taxonomies of disorders and therapeutics.
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From page 60... ...
Using the analogy of a door with multiple locks, Simon suggested that each lock may need to be engaged by a different key, with the relative importance of each key varying from door to door. Even more complexity could arise if efficacy requires each key to engage its lock in a particular order, he said.
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