Unknown Mental Health NIHR-supported project Pregnancy, Children & Inherited Conditions

A New Intervention for Implementation of Pharmacogenetics in Psychiatry (PSY-PGx)

In plain English

AI plain-English summary

A simple blood test could soon tell doctors which antidepressant will work for a patient before they prescribe it. Currently, choosing medication for depression or anxiety is largely trial and error. Patients often try several drugs over months, suffering side effects or no benefit, before finding one that works. This uncertainty stems from genetic differences in how people metabolise drugs. Two liver enzymes, CYP2C19 and CYP2D6, break down most common psychiatric medications, but variants in the genes encoding them can make someone a "poor" or "ultra-rapid" metaboliser. Previous studies showing the value of pharmacogenetic testing were all industry-funded, used commercial panels with undisclosed algorithms, and were never independently replicated. This trial is the first international, non-commercial, randomised controlled test of a simple, transparent approach: checking just these two enzymes before prescribing. If successful, it could make psychiatric prescribing faster, safer, and more effective for millions of NHS patients. The impact would be felt in GP surgeries and psychiatric clinics, where a single test result could replace weeks of guesswork, reducing side effects and improving treatment outcomes for common mental disorders.

View original technical description
summary Recent studies have shown that genotyping of genes encoding drug-metabolising enzymes can identify which patient benefits most from certain psychotropic medication for common mental disorders. In this sense,pharmacogenetic (PGx) testing can help reduce uncertainty in the treatment selection process. Of the genetic factors implicated in treatment response and adverse effects,variants in drug-metabolising enzymes appears to be by far the most important. As such,in 2005,the Dutch Pharmacogenetic Working Group (DPWG) formulated a dosage recommendation based on pharmacogenetic metaboliser status. To date,there have been seven prospective clinical trials that demonstrated clinical benefit in implementing pharmacognetics,though further implementation has been limited as these have all been (at least partly) industry sponsored,used commercial pharmacogenetic combinatorial panels,and used algorithms that were non-diclosed. This study will be the first international,non-commercial,prospective pharmacogenetic study to investigate the impact of taking specific cytochromes (CYP2C19 and CYP2D6) into account when prescribing commonly used medications. It is a two-arm parallel-group multi-centre randomised controlled trial (RCT),comparing the impact of this approach (PSY-PGx group) for relevant efficacy and safety outcomes against TAU.

Researchers

Allan Young (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

A New Intervention for Implementation of Pharmacogenetics in Psychiatry
Using Genetics to Personalise Antipsychotic Treatment
Determining the Clinical Utility of Pre-emptive Pharmacogenetic Testing and Defining Optimal Models for Implementation
Pharmacogenetics Roll Out – Gauging Response To Service (PROGRESS).
Ubiquitous Pharmacogenomics (U-PGx): Making actionable pharmacogenomic data and effective treatment optimization accessible to every European citizen

Original classification

Experimental Medicine and Novel Therapeutics

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