Introduction. The combinatorial pharmacogenomic test has shown the potential
to predict antidepressant response, tolerability, selection, and dosage in
the treatment of a major depressive disorder. A case of successful
management of antidepressant therapy adjustment is reported by using the
combinatorial pharmacogenomic test. Case Report. A 53-year old man, severely
disabled due to a rare genetic disease, Usher syndrome type 3, was treated
with numerous antidepressants. However, episodes of major depression
recurred, along with frequent suicidal thoughts. A combinatorial
pharmacogenomic test was considered to design a potentially effective
antidepressant therapy. Conclusion. According to the results of the
combinatorial pharmacogenomic test, the patient constantly received
inadequate antidepressant therapy, which did not lead to an improvement of
depression due to moderate gene-drug interaction. The patient was prescribed
nortriptyline, which proved to be one of the few most adequate according to
the test. He showed improvement with subjectively more tolerable depression
without suicidal thoughts and episodes of major depression. This case showed
that the combinatorial pharmacogenomic testing may contribute to better
selection of antidepressant therapy.