Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report

In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine...

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Veröffentlicht in:Life (Basel, Switzerland) Jg. 11; H. 7; S. 673
Hauptverfasser: Stäuble, Céline K., Lampert, Markus L., Mikoteit, Thorsten, Hatzinger, Martin, Hersberger, Kurt E., Meyer zu Schwabedissen, Henriette E.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 09.07.2021
MDPI
Schlagworte:
antidepressant drugs
Antidepressants
Anxiety
Case Report
Case reports
Citalopram
Collaboration
COVID-19
depression
Drug dosages
Drug stores
Drug therapy
Glycoproteins
Interdisciplinary aspects
interprofessional relations
Intolerance
Laboratories
Mental depression
Paroxetine
pharmaceutical care
Pharmacists
Pharmacogenetics
Pharmacology
Polymorphism
psychiatry
Remission
Side effects
ABCB1
CYP2D6
antidepressant drugs
vortioxetine
interprofessional relations
pharmaceutical care
depression
psychiatry
CYP2C19
pharmacogenetics
ISSN:2075-1729, 2075-1729
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Zusammenfassung:In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued due to subjective gastrointestinal intolerance. Due to the worsening of the depression after the failed treatment attempts, admission to our clinic became necessary. Herein, owing to the collaboration of psychiatrists with clinical pharmacists, individualized incorporation of pharmacogenetic data into the process of antidepressant selection was enabled. We identified vortioxetine as a suitable therapeutic, namely for being most likely pharmacokinetically unaffected as predicted by pharmacogenetic panel testing and taking into account the current comedication, as well as for its favorable action profile. Herein, our collaborative effort proved to be successful and resulted in the patient’s depression remission and clinic discharge with the interprofessionally selected pharmacotherapy. This exemplary case not only highlights the potential benefits and challenges of pre-emptive pharmacogenetic testing in antidepressant prescription, but also proposes an approach on how to put pharmacogenetics into practice.
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ISSN:2075-1729
2075-1729
DOI:10.3390/life11070673