The potential utility of pharmacogenetic testing in psychiatry.

Kathryn R Gardner,Jay Lombard,Rachel Scott,Francis X Brennan

doi:10.1155/2014/730956

Abstract

Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized treatment plans with the highest likelihood of success. Recently, many studies have been published demonstrating improved patient outcomes and decreased healthcare costs for psychiatric patients who utilize genetic testing. This review will describe evidence supporting the clinical utility of genetic testing in psychiatry, present several case studies to demonstrate use in everyday practice, and explore current patient and clinician opinions of genetic testing.

Highlights

Mental illnesses are extremely prevalent and debilitating
Knowledge of a patient’s genetic background can help clinicians provide a personalized medicine strategy by predicting both drug response and risk for adverse events [7]. Clinicians can utilize this information to compensate for a gene defect or to adjust medication dosage to accommodate the rate at which the patient metabolizes different medications
Clinical response and remission were significantly associated with variants within SLC6A4 and cytochrome P450 2D6 (CYP2D6), as well as serotonin receptor 2A (5HTR2A) and cytochrome P450 1A2 (CYP1A2) [10]

Summary

Introduction

Mental illnesses are extremely prevalent and debilitating. Depression alone is the leading cause of disability worldwide, leading to a significant patient/economic burden, affecting at least 350 million people [1]. Several studies have found genetic variations associated with altered treatment response/efficacy [9, 10] and increased side effect risk [11,12,13,14,15] Genetic testing for such variations can help identify which patients are more or less likely to respond to psychotropics and which are likely to experience an increased side effect burden. Incorporation of this information can drive appropriate treatment choices to improve treatment outcomes [16]

Clinical Utility

Cost Effectiveness

Pharmacogenetic Testing in Everyday Psychiatric Practice

Conclusion

Findings

Future Perspective