The use of pharmacogenomics in the treatment of major depressive disorder (MDD) is supported by study data published in the Journal of Psychiatry Research.

Researchers designed an open-label prospective study to examine the efficacy of pharmacogenomics for patients with MDD in both psychiatric and primary care settings. Pharmacogenomic testing was performed for all patients at baseline (N=1871), using genomic DNA isolated from buccal swabs. Medications were classified as congruent or incongruent via genotyping results. Depressive symptoms were assessed at baseline and at 8 to 12 weeks’ follow-up using the Beck Depression Inventory (BDI).

The total patient cohort experienced a 27.9% reduction in depressive symptoms at follow-up, as well as response (≥50% decrease in BDI score) and remission (BDI score ≤10) rates of 25.7% and 15.2%, respectively. Patients treated by primary care providers had significantly improved symptom reduction rates (31.7% vs 24.9%), response rates (30.1% vs 22.3%), and remission rates (19.5% vs 12.0%) compared with patients treated by psychiatrists (P <.01 for all). Additionally, 16.4% of patients taking medications congruent with their combinatorial pharmacogenomic test experienced remission compared with just 13.9% of patients taking ≥1 incongruent medication (P =.039). Patients taking congruent medications experienced an overall 31% relative improvement in response rate compared with patients taking incongruent medications. Patients treated by primary care providers experienced slightly higher rates of congruence (87.6%) compared with patients treated by psychiatrists (85.2%), though the difference was not statistically significant. 

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Researchers noted that the discrepancy in treatment responses across provider types may result from the higher rates of psychiatric comorbidities in patients treated by psychiatrists. 

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These data support the clinical use of combinatorial pharmacogenetics for patients with MDD. Patient improvement across provider types also suggests that pharmacogenetics may have use in broader treatment settings.


Tanner J-A, Davies PE, Voudouris NC, et al. Combinatorial pharmacogenomics and improved patient outcomes in depression: treatment by primary care physicians or psychiatrists. J Psychiatr Res. 2018;104:157-162.