Citation: Goh SE, Jamuar SS, Chua SE, Yeo DCK, Goh JHY, Chin CH, Karuvetil MZ, Lee EL, Fung DSS, Tan GMY. Pharmacogenomics in psychiatry: Practice recommendations from an Asian perspective (2024). Ann Acad Med Singap. 2024 Dec 26;53(12):734-741. doi: 10.47102/annals-acadmedsg.2024217. PMID: 39748172.

Full text link: https://annals.edu.sg/pharmacogenomics-in-psychiatry-practice-recommendations-from-an-asian-perspective-2024/

 

INTRODUCTION

What is pharmacogenomic?

  • Pharmacogenomic is the study of how genes affect a person’s response to drugs. This field combines pharmacology and genomics.
  • Pharmacogenomic testing in psychiatry is an emerging area with potential clinical application of guiding medication choice and dosing.

CLINICAL IMPACT

What is New

  • This article provides an update on the developments in pharmacogenomic testing in psychiatry and its current position in Singapore’s landscape.
  • Pharmacogenomic testing should be mainly limited to drug-gene pairs with established clinical evidence, such as antidepressants and CYP2C19/CYP2D6.
  • Direct-to-consumer pharmacogenomic panels that assay multiple genes and analyse them via proprietary algorithms are not presently recommended in Singapore’s psychiatric setting due to inconclusive evidence on clinical outcomes.
  • Pharmacogenomic testing in psychiatry is not recommended as standard clinical practice. Exceptions may include concerns about drug concentrations or potential severe adverse drug reactions.

Clinical Implications

  • The practice recommendations can guide healthcare professionals on the utilisation of pharmacogenomic testing in psychiatric practice, particularly as an augmenting tool to guide medication selection and dosing, and limited to the known drug-gene pairs with established clinical evidence.