Lifelong Learning: Clinical Implementation of Pharmacogenetic Decision Support Tools for Antidepressant Drug Prescribing-View Article

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Clinical implementation of pharmacogenetic decision support tools for prescribing antidepressant drugs is discussed. Currently, there is insufficient evidence to support their widespread use, but they may be informative in predicting side effects. Factors limiting the development of a standardized pharmacotherapeutic approach for major depression include heterogeneous depression endophenotypes, lack of reliable biomarkers, and individual differences in drug metabolism. Combinatorial pharmacogenetic decision support tools use algorithms to integrate genetic variants, but there are limitations in study design and methodological weaknesses in clinical trials evaluating their effectiveness. Further research is needed to determine their clinical utility and cost-effectiveness. These tools can improve medication adherence, reduce adverse drug events, and save costs, but evidence supporting genetic markers and pharmacogenetic predictors varies. CYP450 genotyping is the most well-established marker. Further research is needed to determine the clinical utility and cost-effectiveness of these tools, ideally considering both pharmacokinetic and pharmacodynamic factors and supported by rigorous clinical trials.

Keywords

pharmacogenetic decision support tools

predicting side effects

heterogeneous depression endophenotypes

reliable biomarkers

individual differences in drug metabolism

combinatorial pharmacogenetic decision support tools

genetic variants

clinical trials

medication adherence

CYP450 genotyping