Literature DB >> 24018772

Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting.

Daniel K Hall-Flavin1, Joel G Winner, Josiah D Allen, Joseph M Carhart, Brian Proctor, Karen A Snyder, Maureen S Drews, Linda L Eisterhold, Jennifer Geske, David A Mrazek.   

Abstract

OBJECTIVE: The objective was to evaluate the potential benefit of an integrated, five-gene pharmacogenomic test and interpretive report (GeneSight) for the management of psychotropic medications used to treat major depression in an outpatient psychiatric practice.
METHODS: The open-label study was divided into two groups. In the first (unguided) group (n = 113), pharmacogenomic information was not shared until all participants completed the study. In the second (guided) group (n = 114), the pharmacogenomic report was provided to physicians for clinical use. Three depression ratings, the 17-item Hamilton Rating Scale for Depression (HAMD-17), the Quick Inventory of Depressive Symptomatology - Clinician Rated (QIDS-C16), and the Patient Health Questionnaire (PHQ-9), were collected at baseline, and at 2, 4, and 8 weeks.
RESULTS: The guided group experienced greater percent improvement in depression scores from baseline on all three depression instruments (HAMD-17, P < 0.0001; QIDS-C16, P < 0.0001; PHQ-9, P < 0.0001) compared with the unguided group. Eight-week response rates were higher in the guided group than in the unguided group on all three measurements (HAMD-17, P = 0.03; QIDS-C16, P = 0.005; PHQ-9, P = 0.01). Eight-week QIDS-C16 remission rates were higher in the guided group (P = 0.03). Participants in the unguided group who at baseline were prescribed a medication that was most discordant with their genotype experienced the least improvement compared with other unguided participants (HAMD-17, P = 0.007). Participants in the guided group and on a baseline medication most discordant with their genotype showed the greatest improvement compared with the unguided cohort participants (HAMD-17, P = 0.01).
CONCLUSION: These findings replicate previous studies and demonstrate significantly improved depression outcomes with use of GeneSight, an integrated, multigenetic pharmacogenomic testing platform.

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Year:  2013        PMID: 24018772     DOI: 10.1097/FPC.0b013e3283649b9a

Source DB:  PubMed          Journal:  Pharmacogenet Genomics        ISSN: 1744-6872            Impact factor:   2.089


  41 in total

Review 1.  The role of depression pharmacogenetic decision support tools in shared decision making.

Authors:  Katarina Arandjelovic; Harris A Eyre; Eric Lenze; Ajeet B Singh; Michael Berk; Chad Bousman
Journal:  J Neural Transm (Vienna)       Date:  2017-10-29       Impact factor: 3.575

2.  Evidence for Clinical Implementation of Pharmacogenomics in Cardiac Drugs.

Authors:  Amy L Kaufman; Jared Spitz; Michael Jacobs; Matthew Sorrentino; Shennin Yuen; Keith Danahey; Donald Saner; Teri E Klein; Russ B Altman; Mark J Ratain; Peter H O'Donnell
Journal:  Mayo Clin Proc       Date:  2015-06       Impact factor: 7.616

3.  Attitudes on pharmacogenetic testing in psychiatric patients with treatment-resistant depression.

Authors:  Michael J McCarthy; Yucui Chen; Anna Demodena; Eileen Fisher; Shahrokh Golshan; Trisha Suppes; John R Kelsoe
Journal:  Depress Anxiety       Date:  2020-07-15       Impact factor: 6.505

Review 4.  The Outlier in All of Us: Why Implementing Pharmacogenomics Could Matter for Everyone.

Authors:  P H O'Donnell; K Danahey; M J Ratain
Journal:  Clin Pharmacol Ther       Date:  2016-02-15       Impact factor: 6.875

5.  Clinical validity: Combinatorial pharmacogenomics predicts antidepressant responses and healthcare utilizations better than single gene phenotypes.

Authors:  C A Altar; J M Carhart; J D Allen; D K Hall-Flavin; B M Dechairo; J G Winner
Journal:  Pharmacogenomics J       Date:  2015-02-17       Impact factor: 3.550

6.  Integrating Genomics into Psychiatric Practice: Ethical and Legal Challenges for Clinicians.

Authors:  Eric T Ward; Kristin M Kostick; Gabriel Lázaro-Muñoz
Journal:  Harv Rev Psychiatry       Date:  2019 Jan/Feb       Impact factor: 3.732

Review 7.  Pharmacogenomic Testing for Psychotropic Medication Selection: A Systematic Review of the Assurex GeneSight Psychotropic Test.

Authors: 
Journal:  Ont Health Technol Assess Ser       Date:  2017-04-11

Review 8.  Pharmacogenomic testing for neuropsychiatric drugs: current status of drug labeling, guidelines for using genetic information, and test options.

Authors:  Katarzyna Drozda; Daniel J Müller; Jeffrey R Bishop
Journal:  Pharmacotherapy       Date:  2014-02       Impact factor: 4.705

9.  Clinical Utility of Combinatorial Pharmacogenomics-Guided Antidepressant Therapy: Evidence from Three Clinical Studies.

Authors:  C Anthony Altar; Joseph Carhart; Josiah D Allen; Daniel Hall-Flavin; Joel Winner; Bryan Dechairo
Journal:  Mol Neuropsychiatry       Date:  2015-07-31

10.  Clinical Implementation of Pharmacogenetic Decision Support Tools for Antidepressant Drug Prescribing.

Authors:  Zane Zeier; Linda L Carpenter; Ned H Kalin; Carolyn I Rodriguez; William M McDonald; Alik S Widge; Charles B Nemeroff
Journal:  Am J Psychiatry       Date:  2018-04-25       Impact factor: 18.112

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