Pharmacist assessment of drug-gene interactions and drug-induced phenoconversion in major depressive disorder: a case report.
Antidepressants
CYP2C19
CYP2D6
Case report
Pharmacogenetics
Pharmacogenomics
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
20 01 2022
20 01 2022
Historique:
received:
25
06
2021
accepted:
17
12
2021
entrez:
21
1
2022
pubmed:
22
1
2022
medline:
11
3
2022
Statut:
epublish
Résumé
Response to antidepressant therapy is highly variable among individuals. Pharmacogenomic (PGx) testing presents an opportunity to guide drug selection while optimizing therapy outcomes and/or decreasing the risk for toxicity. A patient with multiple comorbidities, including severe major depressive disorder (MDD), experienced adverse drug events and undesirable response to multiple antidepressant medications (i.e., bupropion, escitalopram, and venlafaxine). A clinical pharmacist assessed significant drug-gene, drug-drug, and drug-drug-gene interactions as well as other clinical factors to provide recommendations for antidepressant therapy optimization. This case highlights the importance of PGx testing and the key role of pharmacists in identifying and mitigating drug-related problems and optimizing drug therapy in patients with MDD.
Sections du résumé
BACKGROUND
Response to antidepressant therapy is highly variable among individuals. Pharmacogenomic (PGx) testing presents an opportunity to guide drug selection while optimizing therapy outcomes and/or decreasing the risk for toxicity.
CASE PRESENTATION
A patient with multiple comorbidities, including severe major depressive disorder (MDD), experienced adverse drug events and undesirable response to multiple antidepressant medications (i.e., bupropion, escitalopram, and venlafaxine). A clinical pharmacist assessed significant drug-gene, drug-drug, and drug-drug-gene interactions as well as other clinical factors to provide recommendations for antidepressant therapy optimization.
CONCLUSION
This case highlights the importance of PGx testing and the key role of pharmacists in identifying and mitigating drug-related problems and optimizing drug therapy in patients with MDD.
Identifiants
pubmed: 35057765
doi: 10.1186/s12888-021-03659-4
pii: 10.1186/s12888-021-03659-4
pmc: PMC8772164
doi:
Substances chimiques
Antidepressive Agents
0
Venlafaxine Hydrochloride
7D7RX5A8MO
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
46Informations de copyright
© 2022. The Author(s).
Références
J Neural Transm (Vienna). 2009 Jun;116(6):667-77
pubmed: 19434367
Medicine (Baltimore). 2003 Jul;82(4):282-90
pubmed: 12861106
Can Pharm J (Ott). 2016 May;149(3):139-52
pubmed: 27212965
Clin Pharmacol Ther. 2019 Dec;106(6):1280-1289
pubmed: 31099895
Genet Med. 2019 May;21(5):1224-1232
pubmed: 31048813
Ther Adv Psychopharmacol. 2014 Jun;4(3):130-8
pubmed: 25057346
Clin Pharmacol Ther. 2015 Aug;98(2):127-34
pubmed: 25974703
Pharmacopsychiatry. 2003 Nov;36 Suppl 3:S235-43
pubmed: 14677085
J Cardiovasc Pharmacol. 2003 Jun;41(6):934-7
pubmed: 12775973
Clin Lab Med. 2008 Dec;28(4):619-26
pubmed: 19059066
Am J Psychiatry. 2006 Nov;163(11):1905-17
pubmed: 17074942
Clin Geriatr Med. 2017 May;33(2):257-281
pubmed: 28364995
Pharmacogenomics. 2020 Jun;21(8):559-569
pubmed: 32301649
Front Pharmacol. 2020 Sep 11;11:575540
pubmed: 33041820
Annu Rev Med. 2006;57:119-37
pubmed: 16409140
Int J Mol Sci. 2018 Jan 12;19(1):
pubmed: 29329256
Genet Med. 2021 Mar;23(3):461-470
pubmed: 33041335
Curr Pharm Des. 2010;16(2):136-44
pubmed: 20205659
Expert Rev Clin Pharmacol. 2014 Jul;7(4):533-44
pubmed: 24745854
Front Psychiatry. 2020 Mar 12;11:94
pubmed: 32226396
J Pharm Sci. 2012 Feb;101(2):868-78
pubmed: 22081364
Clin Transl Sci. 2017 May;10(3):133-142
pubmed: 28160433
Consult Pharm. 2015 May;30(5):287-90
pubmed: 25979128
Med Lett Drugs Ther. 2016 Dec 5;58(1509):153
pubmed: 27906148
Can J Cardiol. 2005 Aug;21(10):857-64
pubmed: 16107909
Nature. 2015 Oct 15;526(7573):343-50
pubmed: 26469045
Pharmacogenomics. 2019 Jul;20(10):709-718
pubmed: 31368837
Clin Biochem Rev. 2006 Feb;27(1):17-25
pubmed: 16886044
Clin Pharmacol Ther. 2018 May;103(5):778-786
pubmed: 29460415
Adv Pharmacol. 2018;83:297-331
pubmed: 29801579
Consult Pharm. 2012 Jan;27(1):24-30
pubmed: 22231995
J Cardiovasc Electrophysiol. 1993 Apr;4(2):206-10
pubmed: 8269292
JAMA. 2016 Oct 25;316(16):1659-1660
pubmed: 27669484
JAMA Psychiatry. 2014 Sep;71(9):1006-14
pubmed: 25006837
Int J Mol Sci. 2021 May 07;22(9):
pubmed: 34067027
Hum Genomics. 2019 Aug 27;13(1):39
pubmed: 31455423
Psychiatr Serv. 2014 Aug 1;65(8):977-87
pubmed: 24789696