National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, has commenced the preparation of a gene pool of the Indian population suffering from epilepsy. The Institute is gearing up to provide personalized medicine to patients suffering from this condition. It has been one of the key centres which devised a comprehensive epilepsy management strategy.

Besides, the Union Government has expressed its intention to have a centre for advanced research for innovation in mental health and neuro sciences where epilepsy control will be one of the key areas of study.

In personalized medicine, all decisions and practices are customized to an individual patient by use of genetic or other information, said Dr Satish P Chandra, director, NIMHANS.

Right now NIMHANS is in the process of working to focus on pharmacogenomics to address epilepsy. Using this expertise, each patient suffering from epilepsy will be identified with the gene that reacts in an unpredictable manner to various medications administered under normal circumstances.

On studying a patient’s gene pool, reaction to various treatments can be customized. Collating a gene pool of the Indian population is a huge task. There is also need to comprehend the gene pool reaction to drugs and this would at least take five years to provide personalized medicine in India, said Dr Chandra.

Globally, personalized medicine has taken significant strides. Pharmacogenomics holds the promise that drugs might one day be tailor-made for individuals and adapted to each person's own genetic makeup. Environment, diet, age, lifestyle, and state of health all can influence a person's response to medicines, but understanding an individual's genetic makeup is now viewed to be the key to creating personalized drugs with greater efficacy and safety.

Moreover pharma companies will be able to develop drugs based on the proteins, enzymes, and RNA molecules associated with genes and diseases. The accuracy not only will maximize therapeutic effects but also decrease damage to healthy cells, said Dr Chandra.

Instead of the standard trial-and-error method of matching patients with the right drugs, doctors will be able to analyze a patient's genetic profile and prescribe the best available drug therapy from the beginning. Understanding the genetic code will allow a person to make adequate lifestyle and environmental changes at an early age. It can help to prevent or decrease the severity of a genetic disease. An alert of a particular disease susceptibility will allow careful monitoring and treatments can be introduced at the most appropriate stage to maximize their therapy, said the NIMHANS director.

In India, pharmacogenomics is used to a limited degree because of the complexity of finding gene variations that affect drug response, he said.

In India, epilepsy is a growing concern and we are looking to assess this carefully. Current estimates indicate that India has 6 million epilepsy cases. Around 4 per cent of the population would experience a seizure sometime in their life. Global incidence is 50 million with a prevalence rate of 0.7 per cent, of which 80 per cent are from developing countries.