Pharmacopsychiatry 2024; 57(02): 89
DOI: 10.1055/s-0044-1779568
Abstracts │ XVth Symposium of the Task Force Therapeutic Drug Monitoring of the AGNP
Lecture Abstracts

Pharmacogenetic testing for selection of antidepressant treatment

A. Menke
1   Department of Psychosomatic Medicine and Psychotherapy, Medical Park Chiemseeblick, Bernau am Chiemsee, Germany
2   Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
› Author Affiliations
 

Major depressive disorder (MDD) is one of the most prevalent mental health disorders worldwide, implicating a huge burden for patients and society. Antidepressants represent an essential treatment option. However, more than 50% of the patients do not respond to the first prescribed antidepressant. Therefore several treatment trials are necessary to find the right antidepressant for a specific patient in the clinical context. In addition, adverse effects may occur in more than 25% of antidepressant-treated patients. In this context pharmacogenomic testing may represent a tool to match the individual patient with the right antidepressant and to enhance response-rate and tolerability. Pharmacogenomic decision support tools may help clinicians to select a medication based on clinically actionable variants in pharmacokinetic and pharmacodynamic genes. Guidelines exist for the use of pharmacogenomic testing to support antidepressant selection to enhance safety and tolerability, with robust evidence for genetic variants of the CYP450 enzymes such as CYP2D6 and CYP2C19. Meanwhile, three large controlled studies with more than 3,200 patients with MDD investigated the benefit of pharmacogenetically guided selection of antidepressants. While a significant benefit could not be observed, there was some evidence favoring the pharmacogenetic testing in the analysis of secondary outcome measures. Thus large-scale pharmacogenomic trials are needed to strengthen precision medicine approaches for the management of MDD.



Publication History

Article published online:
12 March 2024

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