title: Using a pharmacogenomic algorithm to guide the treatment of depression.
abstract: The objective of this study was to evaluate the potential benefit of utilizing a pharmacogenomic testing report to guide the selection and dosing of psychotropic medications in an outpatient psychiatric practice. The non-randomized, open label, prospective cohort study was conducted from September 2009 to July 2010. In the first cohort, depressed patients were treated without the benefit of pharmacogenomic testing (the unguided group). A DNA sample was obtained from patients in the unguided group, but the results were not shared with either the physicians or patients until the end of the 8-week study period. In the second cohort (the guided group), testing results were provided at the beginning of the 8-week treatment period. Depression ratings were collected at baseline and after 2 weeks, 4 weeks and 8 weeks of treatment using the Quick Inventory of Depressive Symptomatology, Clinician Rated (QIDS-C16) and the 17-item Hamilton Rating Scale for Depression (HAM-D17). Clinician and patient satisfaction was also assessed. The reduction in depressive symptoms achieved within the guided treatment group was greater than the reduction of depressive symptoms in the unguided treatment group using either the QIDS-C16 (P=0.002) or HAM-D17 (P=0.04). We concluded that a rapidly available pharmacogenomic interpretive report provided clinical guidance that was associated with improved clinical outcomes for depressed patients treated in an outpatient psychiatric clinic setting.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. flavin.daniel@mayo.edu
authors.forename: D K
authors.initials: DK
authors.lastname: Hall-Flavin
authors.forename: J G
authors.initials: JG
authors.lastname: Winner
authors.forename: J D
authors.initials: JD
authors.lastname: Allen
authors.forename: J J
authors.initials: JJ
authors.lastname: Jordan
authors.forename: R S
authors.initials: RS
authors.lastname: Nesheim
authors.forename: K A
authors.initials: KA
authors.lastname: Snyder
authors.forename: M S
authors.initials: MS
authors.lastname: Drews
authors.forename: L L
authors.initials: LL
authors.lastname: Eisterhold
authors.forename: J M
authors.initials: JM
authors.lastname: Biernacka
authors.forename: D A
authors.initials: DA
authors.lastname: Mrazek
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000554:Ambulatory Care Facilities; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D060005:Genotyping Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D044402:Receptor, Serotonin, 5-HT2A / Q000235:genetics*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D044402:Receptor, Serotonin, 5-HT2A; D050486:Serotonin Plasma Membrane Transport Proteins; D003577:Cytochrome P-450 Enzyme System