Although the harm of mental illness is serious,its pathogenesis remains unclear,clinical treatment is not effective,and there are obvious individual differences.Recent precision medical research has discovered the role of gene polymorphism in the individualized treatment of drugs.Based on the three major systems of serotonin,norepinephrine and dopaminergic,this article systematically reviewed the research progress of psychiatric pharmacogenomics and imaging pharmacogenomics studies,and explored in depth the mechanism of action of the brain,the mechanism of drug action,and gene-drug-brain interactions.We found that genetic polymorphisms such as SLC6A4,BDNF,FKBP5,COMT,and dopamine-related receptors were found to correlate with the occurrence of multiple mental disorders and the efficacy of antidepressant treatment,and consequently may be candidates for the diagnosis of related mental disorders.The cortical and subcortical brain regions including the amygdala,the hippocampus,the orbitofrontal cortex,the anterior cingulate cortex and the prefrontal lobe may be the key targets of the effect of different neurotransmitter gene polymorphisms on the biochemical process of psychotropic drugs.These related important brain areas may become biological markers for the diagnosis and treatment of related mental disorders.However,in the establishment of psychotropic drug-gene-neuroimaging-behavior causal chain,there are still many contradictory results and limitations.Therefore,the studies on homogenous clinical trials and epigenetic effects can be recommended as future research trends.