Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting

Daniel K. Hall-Flavin, Joel G. Winner, Josiah D. Allen, Joseph M. Carhart, Brian Proctor, Karen A. Snyder, Maureen S. Drews, Linda L. Eisterhold, Jennifer Geske, David A. Mrazek

Research output: Contribution to journalArticle

112 Scopus citations

Abstract

OBJECTIVE: The objective was to evaluate the potential benefit of an integrated, five-gene pharmacogenomic test and interpretive report (GeneSight) for the management of psychotropic medications used to treat major depression in an outpatient psychiatric practice. METHODS: The open-label study was divided into two groups. In the first (unguided) group (n=113), pharmacogenomic information was not shared until all participants completed the study. In the second (guided) group (n=114), the pharmacogenomic report was provided to physicians for clinical use. Three depression ratings, the 17-item Hamilton Rating Scale for Depression (HAMD-17), the Quick Inventory of Depressive Symptomatology - Clinician Rated (QIDS-C16), and the Patient Health Questionnaire (PHQ-9), were collected at baseline, and at 2, 4, and 8 weeks. RESULTS: The guided group experienced greater percent improvement in depression scores from baseline on all three depression instruments (HAMD-17, P<0.0001; QIDS-C16, P<0.0001; PHQ-9, P<0.0001) compared with the unguided group. Eight-week response rates were higher in the guided group than in the unguided group on all three measurements (HAMD-17, P=0.03; QIDS-C16, P=0.005; PHQ-9, P=0.01). Eight-week QIDS-C16 remission rates were higher in the guided group (P=0.03). Participants in the unguided group who at baseline were prescribed a medication that was most discordant with their genotype experienced the least improvement compared with other unguided participants (HAMD-17, P=0.007). Participants in the guided group and on a baseline medication most discordant with their genotype showed the greatest improvement compared with the unguided cohort participants (HAMD-17, P=0.01). CONCLUSION: These findings replicate previous studies and demonstrate significantly improved depression outcomes with use of GeneSight, an integrated, multigenetic pharmacogenomic testing platform.

Original languageEnglish (US)
Pages (from-to)535-548
Number of pages14
JournalPharmacogenetics and genomics
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2013

Keywords

  • antidepressant
  • genomics
  • pharmacogenomic
  • translational medicine
  • treatment-resistant depression

ASJC Scopus subject areas

  • Molecular Medicine
  • Molecular Biology
  • Genetics
  • Genetics(clinical)

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