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PHARMACOGENOMICS (PGx)

Neurological and Psychiatric PGx Test Panel

Neurological and Psychiatric PGx Test Panel

CYP2C19, CYP2D6, CYP2C9, CYP3A4, CYP3A5, CYP1A2, COMT, HLA-B*1502, ANKK1, ADRA2A, UGT2B15, BCHE

Many of patients with depression do not respond to their first anti depression medications. Response to these medications may be under genetic influence. In addition, the genetic profile of individuals may explain the differences in response to some of anti-seizure, anti- anxiety medications as well as other medications commonly used to treat neurological and psychiatric conditions.

Neurological and Psychiatric Medications

Medication Gene
Carbamazepine, Oxcarbazepine HLA-B*1502
Phenytoin CYP2C9
Brivaracetam, Moclobemide, Clobazam, Sertraline, Citalopram, Escitalopram, Diazepam CYP2C19
Trazodone, Guanfacine, Eszopiclone, Alprazolam, Buspirone,Clonazepam CYP3A4, CYP3A5
Imipramine CYP2C19, CYP2D6
Bupropion ANKK1
Methylphenidate ADRA2A
Dextroamphetamine, Methylphenidate, Lisdexamfetamine, Dexmethylphenidate, Amphetamine COMT
Oxazepam, Lorazepam UGT2B15
Succinylcholine BCHE
Haloperidol, Olanzapine, Iloperidone, Aripiprazole, Pimozide, Risperidone, Thioridazine, Perphenazine, Clozapine, Brexpiprazole,Zuclopenthixol, Mirtazapine, Amitriptyline, Vortioxetine, Venlafaxine, Clomipramine,Desipramine, Doxepin, Duloxetine, Protriptyline, Flupenthixol,Nortriptyline, Fluvoxamine, Paroxetine, Fluoxetine,Donepezil, Fesoterodine, Tolterodine, Atomoxetine, Tetrabenazine, Galantamine, Dextromethorphan-Quinidine CY2D6

Frequency of Cytochrome P450 (CYP2D6, CYP2C9, CYP2C19) Metabolizer Types in the population

Cytochrome Poor metabolizer Intermediate metabolizer Normal metabolizer Rapid or ultra-rapid metabolizer
CYP2D6 4-7% 9-35% 50-90% 2-3%
CYP2C9 3% 30% 68% N/A
CYP2C19 2-20% 24-36% 14-44% 30%

Drug To Drug Interaction

For drug-drug interactions, please go to Flockhart Table ™

References

  • Evans WE, McLeod HL. Pharmacogenomics -- Drug Disposition, Drug Targets, and Side Effect. The New England Journal of Medicine. 2003;348(6):538-549.
  • Filippo Corponi, Chiara Fabbri, Alessandro Serretti, Pharmacogenetics and Depression: A Critical Perspective Pharmacogenetics and Depression: A Critical Perspective. Psychiatry Investig. 2019 Sep; 16(9): 645–653
  • Junji Saruwatari , Takateru Ishitsu , Kazuko Nakagawa , Update on the Genetic Polymorphisms of Drug-Metabolizing Enzymes in Antiepileptic Drug Therapy. Pharmaceuticals (Basel). 2010 Aug 20;3(8):2709-2732
  • https://cpicpgx.org/genes-drugs
  • https://www.fda.gov/drugs/science-and-research-drugs/table-pharmacogenomic-biomarkers-drug-labeling
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