Pharmacogenetic testing for the guidance of psychiatric treatment: a multicenter retrospective analysis.
OBJECTIVE
We investigated the association between clinical outcome and the recommendations of a pharmacogenetic test (Neuropharmagen) in patients with a variety of psychiatric conditions whose previous treatment regimen had failed.


METHODS
This retrospective, naturalistic, multicenter study included adult psychiatric patients (depression, psychosis, anxiety, bipolar, etc.) who had been seen at 3 private clinics. All patients had received pharmacogenetic testing (Neuropharmagen) and were classified depending on whether or not their post-test treatment regimen followed the test recommendations. Clinical severity was assessed with the Clinical Global Impression of Severity (CGI-S) at baseline (pre-test) and 3-month follow-up, and adverse events were recorded.


RESULTS
182 patients were available for analysis. After multivariate adjustment, patients whose treatment followed the test recommendations had odds of improvement about 4 times greater than patients whose treatment did not follow the recommendations (adjusted OR=3.86, 95%CI 1.36-10.95; p=0.011). Importantly, psychiatric diagnosis did not significantly affect the odds of improvement. Also, in the subpopulation with baseline CGI-S score >3 (N=170), the rate of stabilization at follow-up (defined as CGI-S≤3) was significantly higher in patients whose treatment followed the pharmacogenetic recommendations (p=0.033). There was no apparent difference in the incidence of adverse events (6 patients in each group).


CONCLUSIONS
Non-drug naïve patients whose treatment followed the recommendations of pharmacogenetic testing were more likely to improve their condition than patients whose treatment did not. These results are consistent with previous clinical research on depressed patients, and this study also suggests that this benefit can be extended to psychiatric conditions other than depression.
1Innovation Department,AB-Biotics SA,Barcelona,Spain.
Jordi
http://orcid.org/0000-0002-0128-8363
J
Espadaler
1Innovation Department,AB-Biotics SA,Barcelona,Spain.
Miquel
M
Tuson
2Center Dr. Lopez-Ibor SA,Madrid,Spain.
Jose Miguel
JM
Lopez-Ibor
3Quibor SL,Madrid,Spain.
Franciso
F
Lopez-Ibor
4Department of Psychiatry,College of Medicine,Complutense University of Madrid,Madrid,Spain.
Maria Ines
MI
Lopez-Ibor
D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D001714:Bipolar Disorder / Q000188:drug therapy; D003866:Depressive Disorder / Q000188:drug therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D016017:Odds Ratio; D000071185:Pharmacogenomic Testing; D057285:Precision Medicine; D011618:Psychotic Disorders / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs
anxiety; bipolar disorder; depression; genomics; personalized medicine; pharmacogenetics; psychiatric treatment; psychotic disorder