Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

Lisa C Brown¹, Gwyneth Zai², James L Kennedy², Daniel J Müller³, Emytis Tavakoli⁴, Chad Bousman⁵, Abdullah Al Maruf⁶

Affiliations

¹ Great Scott!, Surf City, North Carolina, USA.
² Tanenbaum Centre for Pharmacogenetics, Neurogenetics Section, Molecular Brain Sciences Research Department, Campbell Family Mental Health Research Institute, 250 College St, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Pharmacogenetics Research Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wurzburg, Wurzburg, Germany; Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.
⁴ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁵ Department of Medical Genetics, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada; Department of Physiology & Pharmacology, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada.
⁶ The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, 750 McDermot Avenue West, Winnipeg, Manitoba R3E 0T5, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: abdullah.maruf@umanitoba.ca.

PMID: 40348416
DOI: 10.1016/j.psc.2025.01.004

Review

Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

Lisa C Brown et al. Psychiatr Clin North Am. 2025 Jun.

. 2025 Jun;48(2):257-264.

doi: 10.1016/j.psc.2025.01.004. Epub 2025 Mar 4.

Authors

Lisa C Brown¹, Gwyneth Zai², James L Kennedy², Daniel J Müller³, Emytis Tavakoli⁴, Chad Bousman⁵, Abdullah Al Maruf⁶

Affiliations

¹ Great Scott!, Surf City, North Carolina, USA.
² Tanenbaum Centre for Pharmacogenetics, Neurogenetics Section, Molecular Brain Sciences Research Department, Campbell Family Mental Health Research Institute, 250 College St, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Pharmacogenetics Research Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wurzburg, Wurzburg, Germany; Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.
⁴ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁵ Department of Medical Genetics, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada; Department of Physiology & Pharmacology, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Alberta, Canada.
⁶ The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Alberta, Canada; College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, 750 McDermot Avenue West, Winnipeg, Manitoba R3E 0T5, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: abdullah.maruf@umanitoba.ca.

PMID: 40348416
DOI: 10.1016/j.psc.2025.01.004

Abstract

Pharmacogenomic (PGx) testing is an evidence-based strategy to optimize the selection and dosing of certain psychotropic medications. An individual's genetics play a role in medication response through pharmacokinetic and pharmacodynamic mechanisms. The current evidence base of psychiatric PGx mainly focuses on the metabolism of psychotropics through the cytochrome P450 (CYP) system. PGx testing and decision support tools are not yet standardized, resulting in variations in interpretation and prescribing recommendations. Clinicians are encouraged to use PGx results as part of the clinical picture, in addition to the patient's overall clinical profile, in determining a personalized treatment plan for their patients.

Keywords: Implementation; Mental health; Pharmacogenetics; Pharmacogenomics; Precision medicine; Psychiatry.

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Conflict of interest statement

Disclosure L.C. Brown is the Founder of Great Scott! and is an employee and stockholder of Axsome Therapeutics. J.L. Kennedy is a member of the Scientific Advisory Board of Myriad Neuroscience (unpaid). J.L. Kennedy is also an author of several patents relating to pharmacogenetic tests for psychiatric medications D.J. Muller is also a co-inventor on two patents assessing risk for antipsychotic-induced weight gain and served as ad hoc consultant for TEMPUS, Inc. C. Bousman is the founder of and holds equity in Sequence2Script Inc. The remaining authors have no conflicts of interest to declare.

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Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

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Psychiatric Pharmacogenomic Testing: A Primer for Clinicians

Authors

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Abstract

Conflict of interest statement

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