Mental illnesses are a significant burden to individuals and their families. Moreover, the cost to the global economy is enormous, accounting for roughly one-third of the total economic burden among all non-communicable diseases, which also includes cardiovascular disease, chronic respiratory disease, cancer, and diabetes.1 Medication therapy can be a crucial arm in successfully treating mental health disorders. However, healthcare providers are frequently challenged to identify which medications will work best and at what optimized dosage.2 For antidepressants alone, a range of pharmaceutical therapies with differing modes of action is available. Yet only about one-third of patients initially prescribed medication for a mental health disorder actually experience relief, leading to many months or even years of trial and error with medications and dosages.3 Additionally, adverse side effects are surprisingly common and a contributing factor in a patient’s decision to terminate their treatment plan.4-6 Pharmacogenetic testing offers a more selective and personalized approach to prescription decisions.
The FDA lists information on pharmacogenetic biomarkers for more than 20 medications intended for psychotropic therapy.7 Additionally, the Clinical Pharmacogenetic Implementation Consortium (CPIC), recently issued guidelines for the dosing of tricyclic antidepressants that take genetic marker information into account.8 Both sources highlight the emerging role that pharmacogenetic testing plays in making targeted mental health treatment decisions.
Complete list of medications with information on pharmacogenetic testing by the FDA
Gene Tests Included in the Mental Health Panel
|GENE TESTS||EFFECT ON MENTAL HEALTH MEDICATIONS|
|CYP2D6||Responsible for the metabolism of up to 25 percent of frequently prescribed drugs such as SSRIs, SNRIs, tricyclic antidepressants, and antipsychotics.9|
|CYP2C19||Essential in the breakdown of select SSRIs, tricyclic antidepressants, atypical antipsychotic and benzodiazepine medications.9|