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Effectiveness of Genotype-Specific Tricyclic Antidepressant Dosing in Patients With Major Depressive Disorder

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Key Points Question Does pharmacogenetics-informed (CYP2D6 and CYP2C19 genotypes) dosing of tricyclic antidepressants result in faster attainment of therapeutic plasma concentrations, higher effectiveness, and fewer and less severe adverse effects… Click to show full abstract

Key Points Question Does pharmacogenetics-informed (CYP2D6 and CYP2C19 genotypes) dosing of tricyclic antidepressants result in faster attainment of therapeutic plasma concentrations, higher effectiveness, and fewer and less severe adverse effects compared with usual treatment? Findings In this randomized clinical trial of 111 patients with major depressive disorder, dosing based on preemptive pharmacogenetic testing led to faster attainment of therapeutic plasma concentrations and potentially fewer and less severe adverse effects. No effect on depressive symptoms was found. Meaning These findings indicate that pharmacogenetics-informed dosing of tricyclic antidepressants can be safely applied and contributes to personalized antidepressant treatment.

Keywords: effectiveness genotype; depressive disorder; patients major; major depressive

Journal Title: JAMA Network Open
Year Published: 2023

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