Pharmacogenomics in mental health

Tuesday, 25 February 2020

Pharmacogenomic-informed prescribing can improve outcomes for patients with major depressive disorder being managed in the community. Take for example, Jane who is a 53-year-old experiencing depression and self-esteem issues.

Think Pathology. Think Clinpath. PgxThere are many different medications available to Doctors and the choice can sometimes be overwhelming. Finding the most appropriate medication and dose can be difficult – one patient’s clinical response to a particular medication can be quite different to another patient treated with the same medication at the same dose. 

So, what can pharmacogenomics uncover?

In Jane's case, the test identified that she is a CYP2D6 poor metaboliser and is not a good candidate for tricyclic antidepressants. The test identified her CYP2C19 status as “normal metaboliser”, therefore the antidepressant Citalopram would be recommended as it is metabolised through CYP2C19, not CYP2D6, and would be a potentially better starting point.

Approximately 50% of patients with depression respond well to their initial antidepressant. For the remainder, a period of prolonged trial and error is often needed to assess responses to each medication at each dose.

Indeed, less than 50% of patients with depression achieve remission of their illness within 12 months of starting antidepressant medication.

The Sonic PGx Panel is a pharmacogenomic test that provides personalised guidance on medications and dose according to your patient’s genetic variation.

Knowing more about how Jane’s genetic profile could influence her response to medication can guide treatment decisions.

A healthcare provider can address her fears by minimising the risk of side-effects and start with a medication that has better potential for success.

Therapeutic drug monitoring for a wide range of psychotropic medications, including clozapine, is also available through your local Sonic Healthcare pathology laboratory. 

For further information, please refer to our website, www.sonicgenetics.com.au or contact Clinpath’s Sonic Genetics product expert Jill Hall. Jill is contactable via M: 0408 819 430 or E: jhall@clinpath.com.au