1 Office of Translational Research and Residency Programs, Tabula Rasa HealthCare, Moorestown, New Jersey.
Sr Care Pharm. 2024 Apr 1;39(4):143-150. doi: 10.4140/TCP.n.2024.143.
The case discussion demonstrates the benefit of using Pharmacogenomic (PGx) results to aid in the selection of antidepressant therapy and improve response to treatment. Nearly half of patients diagnosed with major depressive disorder fail initial therapy and may require multiple trials of antidepressants. Genetic variation in several metabolic enzymes contribute to the variable response to antidepressant therapy. PGx testing provides an opportunity to inform antidepressant selection and optimize therapeutic outcomes, while minimizing risk of adverse events. A 79-year-old female who had been experiencing a suboptimal response to escitalopram following dose escalation over a period of three years was referred for a PGx consultation. A clinical pharmacist assessed significant drug-gene, drug-drug, and drug-drug-gene interactions, and relevant clinical information to recommend alternative antidepressant therapy, which resulted in mood improvement.
该病例讨论展示了使用药物基因组学（PGx）结果来辅助选择抗抑郁治疗和提高治疗反应的益处。近一半被诊断为重度抑郁症的患者初始治疗失败，可能需要多次尝试使用抗抑郁药。几种代谢酶的遗传变异导致对抗抑郁治疗的反应存在差异。PGx 检测提供了一个机会，可以告知抗抑郁药物的选择，并优化治疗效果，同时将不良反应的风险降到最低。一名 79 岁女性在三年内逐渐增加剂量后，仍对依西酞普兰的反应不理想，因此被转介进行 PGx 咨询。临床药师评估了重要的药物-基因、药物-药物和药物-药物-基因相互作用，以及相关的临床信息，以推荐替代的抗抑郁治疗方案，这导致了情绪的改善。
