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Pharmacogenetic Testing: Why Is It So Disappointing?

Barbara J Limandri

Journal of Psychosocial Nursing and Mental Health Services

|April 2, 2019

Summary

Pharmacogenetic testing, initially promising for personalized psychotropic medication, has disappointed clinicians. Current tests focus on drug metabolism, neglecting crucial pharmacodynamics, limiting individualized treatment effectiveness.

Area of Science:

Pharmacology
Genetics
Psychiatry

Background:

Pharmacogenetic testing was FDA-approved in 2005 to guide psychotropic medication prescribing.
It aimed to reduce trial-and-error prescribing for individualized treatment.
Clinicians have found current pharmacogenetic testing disappointing in practice.

Purpose of the Study:

To discuss the advantages and disadvantages of pharmacogenetic testing in psychotropic medication prescription.
To highlight the limitations of current pharmacogenetic testing methods.

Main Methods:

Review of current pharmacogenetic testing practices.
Analysis of the role of cytochrome P450 in drug metabolism.
Consideration of pharmacodynamic factors in drug response.

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Main Results:

Current pharmacogenetic tests primarily assess drug metabolism via the cytochrome P450 system.
These tests do not fully account for pharmacodynamic variability, which significantly impacts drug effects.
The gap between metabolic assessment and individual drug response limits clinical utility.

Conclusions:

Pharmacogenetic testing's current focus on metabolism overlooks crucial pharmacodynamic aspects of drug action.
This limitation hinders its effectiveness in truly individualizing psychotropic medication prescribing.
Further research and development are needed to incorporate pharmacodynamics for improved clinical application.