Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

Lisa C Brown; Gwyneth Zai; James L Kennedy; Daniel J Müller; Emytis Tavakoli; Chad Bousman; Abdullah Al Maruf

doi:10.1016/j.psc.2025.01.004

Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

Psychiatr Clin North Am. 2025 Jun;48(2):257-264. doi: 10.1016/j.psc.2025.01.004. Epub 2025 Mar 4.

Authors

Lisa C Brown¹, Gwyneth Zai², James L Kennedy², Daniel J Müller³, Emytis Tavakoli⁴, Chad Bousman⁵, Abdullah Al Maruf⁶

Affiliations

¹ Great Scott!, Surf City, North Carolina, USA.
² Tanenbaum Centre for Pharmacogenetics, Neurogenetics Section, Molecular Brain Sciences Research Department, Campbell Family Mental Health Research Institute, 250 College St, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Pharmacogenetics Research Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wurzburg, Wurzburg, Germany; Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.
⁴ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁵ Department of Medical Genetics, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada; Department of Physiology & Pharmacology, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada.
⁶ The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, 750 McDermot Avenue West, Winnipeg, Manitoba R3E 0T5, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: abdullah.maruf@umanitoba.ca.

PMID: 40348416
DOI: 10.1016/j.psc.2025.01.004

Abstract

Pharmacogenomic (PGx) testing is an evidence-based strategy to optimize the selection and dosing of certain psychotropic medications. An individual's genetics play a role in medication response through pharmacokinetic and pharmacodynamic mechanisms. The current evidence base of psychiatric PGx mainly focuses on the metabolism of psychotropics through the cytochrome P450 (CYP) system. PGx testing and decision support tools are not yet standardized, resulting in variations in interpretation and prescribing recommendations. Clinicians are encouraged to use PGx results as part of the clinical picture, in addition to the patient's overall clinical profile, in determining a personalized treatment plan for their patients.

Keywords: Implementation; Mental health; Pharmacogenetics; Pharmacogenomics; Precision medicine; Psychiatry.

Publication types

Review

MeSH terms

Cytochrome P-450 Enzyme System / genetics
Humans
Mental Disorders* / drug therapy
Mental Disorders* / genetics
Pharmacogenetics*
Pharmacogenomic Testing* / methods
Precision Medicine
Psychotropic Drugs* / pharmacokinetics
Psychotropic Drugs* / therapeutic use

Substances

Psychotropic Drugs
Cytochrome P-450 Enzyme System