Major depression is a frequent condition which variably responds to treatment. In view of its high prevalence, the presence of treatment resistance in major depression significantly impacts on quality of life. Tailoring pharmacological treatment based on genetic polymorphisms is a current trend to personalizing pharmacological treatment in patients with major depressive disorders. Current guidelines for the use of genetic tests in major depression issued by the Clinical Pharmacogenomics Implementation Consortium (CPIC) are based on CYP2D6 and CYP2C19 polymorphisms which constitute the strongest evidence for pharmacogenomic guided treatment. There is evidence of increased clinical response to pharmacological treatment in major depression although largely in non-treatment resistant patients from Western countries. In this study, well characterised participants (N = 15) with complex, largely treatment resistant unipolar major depression were investigated, and clinical improvement was measured at baseline and at week-8 after the pharmacogenomics-guided treatment with the Montgomery Åsberg Depression Rating Scale (MÅDRS). Results suggested a statistically significant improvement (p = 0.01) of 16% at endpoint in the whole group and a larger effect in case of changes in medication regime (28%, p = 0.004). This small but appreciable effect can be understood in the context of the level of treatment resistance in the group. To our knowledge, this is the first study from the Middle East demonstrating the feasibility of this approach in the treatment of complex major depressive disorders.

重度抑郁症是一种常见疾病，对治疗的反应各不相同。鉴于其高患病率，重度抑郁症的治疗耐药性显着影响生活质量。基于基因多态性定制药物治疗是重度抑郁症患者个体化药物治疗的当前趋势。目前临床药物基因组学实施联盟 (CPIC) 发布的重度抑郁症基因检测使用指南基于CYP2D6和CYP2C19多态性，这构成了药物基因组学指导治疗的最有力证据。有证据表明，重度抑郁症对药物治疗的临床反应有所增加，尽管主要是来自西方国家的非治疗耐药患者。在这项研究中，对患有复杂的、很大程度上难治性单相重性抑郁症的特征明确的参与者（N = 15）进行了调查，并在基线和药物基因组学指导治疗后第 8 周使用蒙哥马利阿斯伯格抑郁评定量表测量了临床改善情况（莫德斯）。结果表明，整个组在终点时有 16% 的统计显着改善（p = 0.01），并且在药物治疗方案改变的情况下效果更大（28%，p = 0.004）。这种微小但明显的影响可以在群体的治疗抵抗水平的背景下理解。据我们所知，这是来自中东的第一项研究，证明了这种方法在治疗复杂的重度抑郁症方面的可行性。