Psychiatr. praxi. 2024;25(2):71-75 | DOI: 10.36290/psy.2024.012

The present and the future of pharmacogenetic testing with focus on the pharmacotherapy of depression

prof. MUDr. Eva Češková, CSc.1, 2, MUDr. Petr Šilhán, Ph.D.2
1 Psychiatrická klinika LF MU a FN Brno
2 KPN LF Ostravská univerzita a Oddělení psychiatrie, FN Ostrava

The paper deals with possibilities of pharmacogenetic testing in psychiatry. The greatest progress has been made in depressive disorder. Several expert groups and professional associations specialize on developing guidelines for pharmacogenetics testing. Consensus and high level of evidence have been achieved in genotyping of P450 CYP2D6 and CYP2C19 enzymes. It was found that their activity is associated with efficacy and tolerability of many drugs. Nowadays, the multigenes, mostly commercially produced tests, are becoming important. They can help with choice and adequate dosing of drug in individual patient. Undoubtedly, the pharmacogenetics will play an important role in optimization and individualization of treatment in psychiatry and we should include this topic into life long education in psychiatry.

Keywords: pharmacogenetic testing, psychiatry, guidelines, antidepressants.

Accepted: May 29, 2024; Published: June 3, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Češková E, Šilhán P. The present and the future of pharmacogenetic testing with focus on the pharmacotherapy of depression. Psychiatr. praxi. 2024;25(2):71-75. doi: 10.36290/psy.2024.012.
Download citation

References

  1. Hockings JK, Pasternak AL, Erwin AL, et al. Pharmacogenomics: An evolving clinical tool for precision medicine. Cleve Clin J Med. 2020;87:91-99. Go to original source... Go to PubMed...
  2. Quinlan EB, Banaschewski T, Barker GJ, et al; IMAGEN Consortium. Identifying biological markers for improved precision medicine in psychiatry. Mol Psychiatry. 2020;25(2):243-253. Go to original source... Go to PubMed...
  3. Koopmans AB, Braakman MH, Vinkers DJ, et al. Meta-analysis of probability estimates of worldwide variation of CYP2D6 and CYP2C19. Transl. Psychiatry. 2021;111(11):141. Go to original source... Go to PubMed...
  4. de Leon J. AmpliChip CYP450 test: personalized medicine has arrived in psychiatry. Expert Rev Mol Diagn. 2006;6:277-86. Go to original source... Go to PubMed...
  5. Bousman CA, Bengesser SA, Aitchison KJ, et al. Review and consensus on pharmacogenomic testing in Psychiatry. Pharmacopsychiatry. 2021;54:5-17. Go to original source... Go to PubMed...
  6. Clinical Guideline Annotations [Internet]. Pharm GKB; Available from: https://www.pharmgkb.org/guidelineAnnotations.
  7. Češková E, Valášková I, Pindurová E, et al. Farmakogenetické testy a jejich současné využití v psychiatrické praxi Čes a slov Psychiat. 2022;118(6):237-239.
  8. Baldelli S, Cheli S, Montrasio C, et. al. Therapeutic drug monitoring and pharmacogenetics of antipsychotics and antidepressants in real life settings: A 5-year single centre experience. World J Biol Psychiatry. 2021;22:34-45. Go to original source... Go to PubMed...
  9. Anderson HD, Thant TM, Kao DP, et al. Pharmacogenetic testing among patients with depression in a US managed care population. Clin Transl Sci. 2022;15(7):1644-1653. Go to original source... Go to PubMed...
  10. Trivedi MH. Major depressive disorder in primary care: Strategies for identification.J Clin Psychiatry 2020; 81(2)UT17042BR1C. Go to original source... Go to PubMed...
  11. Minelli A, Barlati S, Baune B. European College of Neuropsychopharmacology (ECNP) Pharmacogenomics and Transcriptomics Network. Evaluating study designs and treatment outcomes of antidepressant pharmacogenetic clinical trials - Challenges and future perspectives. A critical review. Eur Neuropsychopharmacol. 202259:68-81. Go to original source...
  12. Schaars KK, van Westrhenen R, Drakoulis M. Pharmacogenomics and the management of mood disorders - a Review. J Pers Med. 2023;13(7):1183. Go to original source... Go to PubMed...
  13. Wang X, Wang Ch, Zhang Y, Zhuoling A. Effect of pharmacogenomics testing guiding on clinical outcomes in major depressive disorder: A systematic review and meta-analysis of RCT. BMC Psychiatry. 2023;23:334. Go to original source... Go to PubMed...
  14. Vos CF, Ter Hark SE, Schellekens AFA, et al. Effectiveness of genotype-specific tricyclic antidepressant dosing in patients with major depressive disorder: A randomized clinical trial. JAMA Netw Open. 2023;6(5):e2312443. Go to original source... Go to PubMed...
  15. Swen JJ, van der Wouden CH, Manson LE, et al. A 12gene pharmacogenetic panel to prevent adverse drug reactions: An open-label, multicentre, controlled, cluster-randomised crossover implementation study. Lancet. 2023; 401:347-356. Go to original source... Go to PubMed...
  16. Cacabelos V, Naidoo L, Corzo N, et al. Genophenotypic factors and pharmacogenomics in adverse drug reactions. Int. J. Mol. Sci. 2021; 22:13302. Go to original source... Go to PubMed...
  17. Desta Z, Zhao X, Shin JG, et al. Clinical significance of the cytochrome P450 2C19 genetic polymorphism. Clin Pharmacokinet. 2002; 41(12):913-58. Go to original source... Go to PubMed...
  18. van Westrhenen R, Aitchison KJ, Ingelman-Sundberg M, et al. Pharmacogenomics of antidepressants and antipsychotic treatment: How far have we got and where are we going? Front. Psychiatry. 2020;11:94. Go to original source... Go to PubMed...
  19. van Westrhenen R, van Schaik RHN, van Gelder T, et al. Policy and practice review: A first guideline on the use of pharmacogenetics in clinical psychiatric practice. Front. Pharmacol. 2021;12:640032. Go to original source... Go to PubMed...
  20. Morris SA, Alsaidi AT, Verbyla A, et al. Cost effectiveness of pharmacogenetic testing for drugs with Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines: A systematic review. Clin Pharmacol Ther. 2022;112(6):1318-1328. Go to original source... Go to PubMed...
  21. Cilluffo G, Fasola S, Ferrante G, et al. Machine learning: An overview and applications in pharmacogenetics. Genes (Basel). 2021;12(10):1511. Go to original source... Go to PubMed...
  22. Terapeutické monitorování léčiv v psychiatrii [Internet]. Psychiatrická společnost ČLS JEP; 2018. Available from: https://postupy-pece.psychiatrie.cz/lecba/monitorovani-lecby-psychofarmaky/terapeuticke-monitorovani-leciv-v-psychiatrii.
  23. Moschny N, Hefner G, Grohmann R, et al. Therapeutic drug monitoring of second - and third-generation antipsychotic drugs-influence of smoking behavior and inflammation on pharmacokinetics. Pharmaceuticals (Basel). 2021;14(6):514. Go to original source... Go to PubMed...
  24. Bertilsson L. Geographical/interracial differences in polymorphic drug oxidation. Current state of knowledge of cytochromes P450 (CYP) 2D6 and 2C19. Clin Pharmacokinet. 1995;29(3):192-209. Go to original source... Go to PubMed...




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.