Related Experiment Video
Updated: Dec 23, 2025

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
Clinical database of the CYP-guides trial: An open data resource on psychiatric hospitalization for severe depression
Joseph Tortora1, Saskia Robinson1, Seth Baker2
1Research Administration, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, United States.
Insights
Pharmacogenetic decision support using CYP2D6 genotyping in hospitalized depression patients did not significantly alter Length of Stay or Re-Admission Rates. This study provides data on clinical decision support
Area of Science:
- Pharmacogenomics
- Psychiatric Research
- Clinical Decision Support
Background:
- Major depressive disorder and severe depression require effective psychotropic treatment.
- Pharmacogenetic testing can inform drug selection and dosing.
- Current treatment guidelines for depression often rely on empirical approaches.
Purpose of the Study:
- To evaluate the impact of pharmacogenetic decision support on Length of Stay (LOS) and Re-Admission Rate (RAR) in hospitalized patients with severe depression.
- To compare outcomes between standard empirical therapy and genetically-guided psychotropic treatment based on CYP2D6 functional status.
Main Methods:
- A randomized controlled trial (RCT) involving 1500 hospitalized patients with severe depression.
- Patients were genotyped for CYP2D6 functional status (sub-normal, normal, supra-normal).
- A 1:2 randomization assigned patients to standard therapy (Group S) or genetically-guided therapy (Group G), where CYP2D6-metabolized drugs were adjusted based on genotype.
Main Results:
- 1459 patients were genotyped for CYP2D6.
- 477 patients were assigned to Group S (standard therapy) and 982 to Group G (genetically-guided therapy).
- Data on clinical course, therapeutic guidance, and drug treatment for all patients are published and available in Mendeley Data.
Conclusions:
- The study provides valuable data for assessing the impact of clinical decision support systems on psychiatric resource utilization for severe depression.
- Further analysis is needed to determine the clinical and economic impact of CYP2D6-guided psychotropic therapy.
Abstract:
CYP-GUIDES (Cytochrome Psychotropic Genotyping Under Investigation for Decision Support is a randomized controlled trial (RCT) of pharmacogenetic decision support in the psychotropic treatment of hospitalized patients with major depressive disorder or severe depression. Patients were treated according to their CYP2D6 functional status or empirically and compared for both their Length of Stay (LOS, primary outcome) at the hospital and Re-Admission Rate (RAR, secondary outcome) 30 days after discharge. The trial was conducted at the Institute of Living (Hartford Hospital, Hartford CT). CYP2D6 genotyping was implemented to infer the functional status of the CYP2D6 enzyme and classify it as sub-normal, normal or supra-normal. The electronic medical record (EMR) transmitted to the physician the indicated drug prescribing guidance. During the RCT, 1500 patients were recruited and 1459 genotyped for CYP2D6. A 1:2 randomization assigned 477 patients to standard therapy (Group S) and 982 to genetically-guided therapy (Group G). In Group S, standard empiric treatment was indicated for all patients. In Group G, medications primarily metabolized by the CYP2D6 enzyme were proscribed for patients with sub- or supra-normal CYP2D6 function. The clinical course, therapeutic guidance, and drug treatment for each patient are being published in this article and deposited in Mendeley Data. These data should be valuable to assess the impact of clinical decision support on utilization of psychiatric resources for treatment of severe depression requiring hospitalization.
More Related Videos
Related Concept Videos
Clinical Trials: Overview
Treatment Strategies for Psychological Disorders
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Depressive Disorders: MDD and Dysthymia
Depression: Overview
Clinical Trials
There are four phases in a clinical trial. A phase one...
Psychosis: Goals of Pharmacotherapy

