The Emerging Role of Pharmacogenetics: Implications for Clinical Psychiatry

Abstract

Genotyping, especially for drug metabolizing enzymes, could enable more rational, cost-effective and optimal prescribing in future psychopharmacotherapy. Although the advances of pharmacogenetics may have many benefits in clinical practice, the importance of non-genetic factors must also be considered as cultural and environmental factors significantly impinge on response to medications. To clarify the extent pharmacogenetics can be adopted in clinical practice to predict drug response in patients from diverse backgrounds, further studies in different ethnic groups and clinical settings are required.

Antidepressant prescribing in the precision medicine era: a prescriber’s primer on pharmacogenetic tools

“…Ethnicity and its accompanying cultural and environmental factors account for some inter-individual pharmacokinetic and pharmacodynamic genetic variation relevant to antidepressant therapy [ 38 ]. For example, the alleles used to predict CYP2D6 and CYP2C19 metaboliser status vary considerably in frequency between ethnicities [ 39 – 41 ] and tools including CYP2D6 and CYP2C19 do not necessarily measure the same alleles. This is a particularly important issue when contemplating whether to order a pharmacogenetic test for a non-Caucasian patient, in that most of the tools were developed and tested in Caucasian populations and may not include alleles that are rare in in this population but more frequent in people of Asian and/or African descent.…”