Multiple adverse drug reactions and genetic polymorphism testing: A case report with negative result
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Updated: Feb 18, 2026

Candidate Gene Testing in Clinical Cohort Studies with Multiplexed Genotyping and Mass Spectrometry
Published on: June 21, 2018
Ana Lucía Arellano1, Marta Martin-Subero, Mar Monerris
1Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Barcelona Department of Pharmacology, Therapeutics, and Toxicology, Universitat Autònoma de Barcelona, Barcelona Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Barcelona FIDMAG Research Foundation, Barcelona Department of Anesthesiology and Reanimation, Pain Unit, Hospital Universitari Germans Trias i Pujol, Barcelona CICAB Clinical Research Center, Extremadura University Hospital and Medical School, Badajoz, Spain.
Rationale:
Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6.
Patient Concerns:
We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period.
Interventions And Outcomes:
A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency.
Lessons:
Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.
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