Pharmacogenomics in psychiatry - the challenge of cytochrome P450 enzyme phenoconversion and solutions to assist precision dosing

Sam Mostafa; Thomas M. Polasek; Chad A. Bousman; Daniel J. Müeller; Leslie J. Sheffield; Joel Rembach; Carl Mj Kirkpatrick

doi:10.2217/pgs-2022-0104

Pharmacogenomics in psychiatry - the challenge of cytochrome P450 enzyme phenoconversion and solutions to assist precision dosing

Sam Mostafa, Thomas M. Polasek, Chad A. Bousman, Daniel J. Müeller, Leslie J. Sheffield, Joel Rembach, Carl Mj Kirkpatrick

Centre for Medicine Use and Safety

Research output: Contribution to journal › Review Article › Research › peer-review

18 Citations (Scopus)

Abstract

Pharmacogenomic (PGx) testing of cytochrome P450 (CYP) enzymes may improve the efficacy and/or safety of some medications. This is facilitated by increased availability and affordability of genotyping, the development of clinical practice PGx guidelines and regulatory support. However, the common occurrence of CYP phenoconversion, a mismatch between genotype-predicted CYP phenotype and the actual CYP phenotype, currently limits the application of PGx testing for precision dosing in psychiatry. This review proposes a stepwise approach to assist precision dosing in psychiatry via the introduction of PGx stewardship programs and innovative PGx education strategies. A future perspective on delivering precision dosing for psychiatrists is discussed that involves innovative clinical decision support systems powered by model-informed precision dosing.

Original language	English
Pages (from-to)	857-867
Number of pages	11
Journal	Pharmacogenomics
Volume	23
Issue number	15
DOIs	https://doi.org/10.2217/pgs-2022-0104
Publication status	Published - 1 Oct 2022

Keywords

pharmacogenomics
phenoconversion dose optimisation
psychiatry

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10.2217/pgs-2022-0104Licence: CC BY

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abstract = "Pharmacogenomic (PGx) testing of cytochrome P450 (CYP) enzymes may improve the efficacy and/or safety of some medications. This is facilitated by increased availability and affordability of genotyping, the development of clinical practice PGx guidelines and regulatory support. However, the common occurrence of CYP phenoconversion, a mismatch between genotype-predicted CYP phenotype and the actual CYP phenotype, currently limits the application of PGx testing for precision dosing in psychiatry. This review proposes a stepwise approach to assist precision dosing in psychiatry via the introduction of PGx stewardship programs and innovative PGx education strategies. A future perspective on delivering precision dosing for psychiatrists is discussed that involves innovative clinical decision support systems powered by model-informed precision dosing.",

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AU - Mostafa, Sam

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AU - Sheffield, Leslie J.

AU - Rembach, Joel

AU - Kirkpatrick, Carl Mj

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Pharmacogenomics in psychiatry - the challenge of cytochrome P450 enzyme phenoconversion and solutions to assist precision dosing

Abstract

Keywords

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