Practical implications of pharmacogenetics in antidepressant treatment : the case of amitriptyline

Abstract

A poster presentation regarding practical implications of pharmacogenetics in antidepressant treatment: the case of amitriptyline. Metabolism, a key player in the dose-exposure-response chain, is a focus of promising genetically-oriented investigations underpinning the usefulness of genetic testing in the pharmacokinetic field. Several pharmaceutical companies are today integrating pharmacogenetic aspects in product labels and actionable genotype-guided dosing recommendations are available. Conversely, many questions related to the implementation of personalised psychiatric therapy remain unanswered. Objectives: Investigate the incidence and impact of genetic polymorphisms in patients receiving treatment for depression in Malta. Determine allele frequencies of both CYP2D6 and CYP2C19 and examine potential additive effects which would support combined dosing recommendations. Evaluate genotype-phenotype association in relation to metaboliser status, measured blood drug/metabolite concentrations and clinical outcome. Assess feasibility and clinician perception of pharmacogenetic-guided individualisation of treatment for depression, compared to the current standard of psychiatric care. Analyse effect of regulatory initiatives in supporting the implementation of pharmacogenomics in drug surveillance and clinical practice. Pharmacoeconomic analysis of routine genotyping and worth of engineering point-of-care tests.