Lisa B Namerow1, Sophia A Walker2, Mirela Loftus3, Jeffrey R Bishop4, Gualberto Ruaño2,5, Salma Malik3. 1. Associate Professor of Pediatrics and Psychiatry, University of Connecticut School of Medicine, Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Ave, Hartford, CT, 06019, USA. lnamerow@connecticutchildrens.org. 2. Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06032, USA. 3. Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Ave, Hartford, CT, 06019, USA. 4. Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Department of Psychiatry, University of Minnesota Medical School, 508 Harvard St SE, Minneapolis, MN, 55455, USA. 5. Institute of Living at Hartford Hospital, Genomas Laboratory of Personalized Health, 67 Jefferson Street, Hartford, CT, 06106, USA.
Abstract
PURPOSE OF REVIEW: This paper aims to acquaint child and adolescent psychiatrists with the field of pharmacogenomics (PGX) and review the most up-to-date evidence-based practices to guide the application of this field in clinical care. RECENT FINDINGS: Despite much research being done in this area, the field of PGX continues to yield controversial findings. In the adult world, studies have focused on the impact of combinatorial gene panels that guide medication selection by providing reports that estimate the impact of multiple pharmacodynamic and pharmacokinetic genes, but to date, these have not been directly examined in younger patient populations. Pharmacokinetic genes, CYP2D6 and CYP2C19, and hypersensitivity genes, HLA-A and HLA-B, have the strongest evidence base for application to pharmacotherapy in children. Although the field is evolving, and the evidence is mixed, there may be a role for PGX testing in children to help guide dosing and monitoring strategies. However, evidence-based medicine, rather than PGX testing, continues to play the lead role in guiding medication selection in pediatric psychopharmacology.
PURPOSE OF REVIEW: This paper aims to acquaint child and adolescent psychiatrists with the field of pharmacogenomics (PGX) and review the most up-to-date evidence-based practices to guide the application of this field in clinical care. RECENT FINDINGS: Despite much research being done in this area, the field of PGX continues to yield controversial findings. In the adult world, studies have focused on the impact of combinatorial gene panels that guide medication selection by providing reports that estimate the impact of multiple pharmacodynamic and pharmacokinetic genes, but to date, these have not been directly examined in younger patient populations. Pharmacokinetic genes, CYP2D6 and CYP2C19, and hypersensitivity genes, HLA-A and HLA-B, have the strongest evidence base for application to pharmacotherapy in children. Although the field is evolving, and the evidence is mixed, there may be a role for PGX testing in children to help guide dosing and monitoring strategies. However, evidence-based medicine, rather than PGX testing, continues to play the lead role in guiding medication selection in pediatric psychopharmacology.
Authors: Lisa B Namerow; Laura B Ramsey; Salma Malik; Samuele Cortese; Jeffrey R Strawn Journal: J Am Acad Child Adolesc Psychiatry Date: 2021-11-10 Impact factor: 8.829
Authors: Laura B Ramsey; Lisa B Namerow; Jeffrey R Bishop; J Kevin Hicks; Chad Bousman; Paul E Croarkin; Carol A Mathews; Sara L Van Driest; Jeffrey R Strawn Journal: J Am Acad Child Adolesc Psychiatry Date: 2020-08-26 Impact factor: 13.113