Abstract
Introduction Pharmacogenetics (PGx) is a well-researched tool to
improve pharmacotherapy. So far, it has not been implemented into daily
practice in Germany. In psychopharmacology, substantial benefit can be
expected by using PGx due to the excessive CYP metabolism of the
psychotropic drugs as well as already discovered target polymorphisms
(e. g., serotonin receptor).
Methods An evaluation of a naturalistic pharmacist-led pilot
implementation of PGx testing in a psychiatric hospital in patients
undergoing inpatient treatment for major depressive disorder was conducted.
Length of stay, number of antidepressant switches, and rehospitalization
rates were analyzed. A PGx-tested intervention cohort of n=49 was
retrospectively compared to a control cohort of n=94 patients.
Results The intervention cohort showed significantly shorter stays
than the control, after correction of the length of hospital stay and the
time to genotyping results (mean intervention: 36.3 d (SD: ±19.3 d);
control: 46.6 d (±19.1 d); p=0.003). Antidepressant-
naïve patients had the largest benefit from the PGx testing
(intervention: 24.7 d (±13.5 d); control: 50.2 d (±22.5 d);
p < 0.001. The number of antidepressant switches during the entire
stay did not differ between the groups: 0.41 (0.64) vs. 0.21 (0.46);
p=0.063 [95% CI −0.01–0.40]).
Discussion Depressed patients, especially treatment-naïve,
seem to benefit from PGx testing prior to treatment. Although the results of
this retrospective evaluation are promising, more systematic prospective
studies are needed to assess the effect of PGx testing on the treatment of
major depressive disorder.
Asymmetry in cortical thickness and subcortical volume in treatment-naïve major depressive disorder
