In addition to identifying therapeutic targets, molecular genetic variation may also be used to personalize therapeutic options for patients. Such pharmacogenomics approaches have been extraordinarily successful in personalizing cancer care and elucidating treatment pathways (Wheeler et al., 2013). The genetic architecture of clinically relevant psychological traits and psychiatric disorders is more complex and any such diagnostic genetic panel for these highly polygenic conditions should be viewed with extreme caution. Nonetheless, genetic research is currently bearing clinically-applicable fruit - for example, rs16969968 within CHRNA5, is a common missense polymorphism strongly associated with tobacco smoking (b=1.03, p≈3×10−73 (Tobacco and Genetics, 2010). This locus moderates the efficacy of treatment and influence numbers needed to treat [NNT (Bierut et al., 2014)]; one study found that while 4 individuals with the high-risk smoking haplotype needed to be treated to benefit one individual (NNT), the corresponding estimate for those with the low-risk haplotype was >1000 (Chen et al., 2012). Further, inspired by associations between FKBP5 and stress-related psychopathology, initial trials of FKBP5 inhibitors in rodent models of stress have produced promising results (Gaali et al., 2015).
