{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:45:06Z","timestamp":1792633506366,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T00:00:00Z","timestamp":1669075200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of the study was to evaluate the ability of a combinatorial pharmacogenomic test to predict medication blood levels and relative clinical improvements in a selected pediatric population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study enrolled patients between ages 3 to 18 years who presented to a pediatric emergency department with acute psychiatric, behavioral, or mental health crisis and\/or concerns, and had previously been prescribed psychotropic medications. Patients received combinatorial pharmacogenomic testing with medications categorized according to gene-drug interactions (GDIs); medications with a GDI were considered \u201cincongruent,\u201d and medications without a GDI were considered \u201ccongruent.\u201d Blood levels for escitalopram, fluoxetine, aripiprazole, and clonidine were evaluated according to level of GDI. Relative clinical improvements in response to the prescribed psychotropic medications were measured using a parent-rated Clinical Global Impression of Improvement (CGI-I) assessment, where lower scores corresponded with greater improvement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 100 patients enrolled, 73% reported taking \u22651 incongruent medication. There was no significant difference in CGI-I scores between patients prescribed congruent versus incongruent medications (3.37 vs 3.68, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.343). Among patients who presented for depression or suicidal ideation, those prescribed congruent medications had significantly lower CGI-I scores compared with those taking incongruent medications (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.036 for depression, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.018 for suicidal ideation). There was a significant association between medication GDI and blood levels for aripiprazole (n = 15, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.01) and escitalopram (n = 10, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.01).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our preliminary findings suggest that combinatorial pharmacogenomic testing can predict medication blood levels and relative outcomes based on medication congruency in children presenting to an emergency department with acute psychiatric\/behavioral crises. Additional studies will be needed to confirm these findings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002871","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T18:00:06Z","timestamp":1669140006000},"page":"6-12","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Pharmacogenomic Profiling of Pediatric Patients on Psychotropic Medications in an Emergency Department"],"prefix":"10.1097","volume":"39","author":[{"given":"Pallavi","family":"Ghosh","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, The University of Alabama at Birmingham Heersink School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Martinez","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham Heersink School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipam","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, The University of Alabama at Birmingham Heersink School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Kenan","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Sciences, The University of Alabama at Birmingham, School of Health Processions, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fowler","sequence":"additional","affiliation":[{"name":"Pediatric Residency Program at Arkansas Children's Hospital, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, 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