Pharmacogenetics & personalized prescribing Tailoring pharmacotherapy to an individual’s genetic makeup to optimize treatment efficacy, while decreasing toxicity and adverse reactions seemed like science fiction only a few years ago. Genomic technology has advanced to allow personalized prescribing for many medications. Indeed, the US FDA’s list of valid genomic biomarkers has expanded to include many SNPs and other gene variants that affect drug efficacy through altered pharmaco kinetics and pharmaco dynamics [1]. Incorporation of gene-array assay technology into mainstream clinical medicine is enhancing patient care. Pharmacogenomic biomarkers include cytochrome P450 hepatic enzyme variants that affect drug metabolism for most psychiatric medications [2,3]. Drugs that target serotonergic, noradrenergic and dopamine systems in psychiatric illness all have pharmaco dynamic-associated gene variants that can predict therapeutic response and serious adverse drug reactions [4–8]. We previously reviewed evidence suggesting pharmacogenetics may be used to individualize drug dependence treatments [9,10]. Here are a few examples of medications for drug dependence disorders for which pharmacogenetic know-how may be useful to increase efficacy.