Beyond the bins: interpreting and discussing pharmacogenomic reports with psychiatric patients

• Type of Material: Article
• Authors: Boadie Dunlop, Emory University
• Language: English
• Date: 2020-03-01
• Publisher: Brazilian Psychiatric Association
• Publication Version: Final Published Version
• Copyright Statement: © SciELO - Scientific Electronic Library Online.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1590/1516-4446-2019-0697
• Title of Journal or Parent Work: Brazilian Journal of Psychiatry
• Volume: 42
• Issue: 2
• Start Page: 111
• End Page: 112
• Grant/Funding Information: None declared
• Keywords: Pharmacogenetics; Behavioral Sciences; Life Sciences & Biomedicine; Clinical testing; Psychiatry; Psychiatric patients; Genetics & Heredity; Science & Technology
• Research Categories: Psychology, Cognitive; Health Sciences, Pharmacology; Biology, Genetics; Biology, Neuroscience

Abstract

With the burgeoning of genetics knowledge in psychiatry, several companies now market pharmacogenomic (PGx) decision support tools (DSTs) to help inform medication selection and dosing for treating depression. A recent meta-analysis of five PGx DSTs tested in randomized controlled trials found a significantly higher remission rate (odds ratio: 1.7, 95% confidence interval: 1.2-2.5) among patients who received PGx-informed treatment compared to those receiving treatment as usual.1 The utility of the PGx tests appears to be greater in patients who have failed to tolerate or respond to at least one prior medication trial.1,2 However, recent statements from the US Food and Drug Administration and a position paper from the American Psychiatric Association have raised concerns about whether and in what circumstances clinicians should order PGx testing.3 Debate about the role that PGx DSTs should play in psychiatric clinical care is likely to continue in the foreseeable future.