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Published on: May 15, 2020
Pharmacogenomics in practice: a case report of personalized inpatient psychiatric care
Alok Madan1, Cory R Walker, Benjamin Weinstein
1The Menninger Clinic, 12301 South Main Street, Houston, TX 77035, USA.
Abstract:
Given variable response to psychotropic intervention, this case highlights the potential of pharmacogenomics to inform medical decision-making in a male with atypical psychosis and depression with longer-standing attentional difficulties. Likely because of his specific COMT polymorphism and intermediate metabolizing liver enzymes, when the patient's stimulant medications were titrated to affect for attentional needs, he became psychotic secondary to a hyperdopaminergic state. Past prescriptions of dopaminergic antidepressant agents (e.g., bupropion) likely would have exacerbated further the problem. The patient's serotonin transporter polymorphism also potentially was associated with SSRI inefficacy and increased side effects. Knowledge of the patient's genetically influenced departure from average response allowed for personalization of pharmacology with clinical improvement across measures of functioning.
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