{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:22:06Z","timestamp":1783430526424,"version":"3.54.6"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Effective pharmacologic treatments for psychiatric disorders are available, but their effect is limited due to patients\u2019 genetic heterogeneity and low compliance-related to frequent adverse events. Only one third of patients respond to treatment and experience remission. Pharmacogenetics is a relatively young field which focusses on genetic analyses in the context of the metabolism and outcome of drug treatment. These genetic factors can, among other things, lead to differences in the activity of enzymes that metabolize drugs. Recently, a clinical guideline was authorized by the Dutch Clinical Psychiatric Association (NVvP) on the clinical use of pharmacogenetics in psychiatry. The main goal was to provide guidance, based on current evidence, on how to best use genotyping in clinical psychiatric practice. A systematic literature search was performed, and available publications were assessed using the GRADE methodology. General recommendations for psychiatric clinical practice were provided, and specific recommendations per medication were made available. This clinical guideline for caregivers prescribing psychotropic drugs is the product of a broad collaboration of professionals from different disciplines, making use of the information available at the Dutch Pharmacogenetics Working Group (DPWG) and the Clinical Pharmacogenetics Implementation Consortium (CPIC) so far. We summarize the relevant literature and all recommendations in this article. General recommendations are provided and also detailed recommendations per medication. In summary we advise to consider genotyping, when there are side effects or inefficacy for CYP2C19 and CYP2D6. When genotype information is available use this to select the right drug in the right dose for the right patient.<\/jats:p>","DOI":"10.3389\/fphar.2021.640032","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T06:48:32Z","timestamp":1618210112000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":40,"title":["Policy and Practice Review: A First Guideline on the Use of Pharmacogenetics in Clinical Psychiatric Practice"],"prefix":"10.3389","volume":"12","author":[{"given":"R.","family":"van Westrhenen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. H. N.","family":"van Schaik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"van Gelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. K.","family":"Birkenhager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. J. F.","family":"Houwink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M.","family":"Bet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. J. G.","family":"Hoogendijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J. M.","family":"van Weelden-Hulshof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1159\/000430915","article-title":"Clinical utility of combinatorial pharmacogenomics-guided antidepressant therapy: evidence from three clinical studies","volume":"1","author":"Altar","year":"2015","journal-title":"Mol. Neuropsychiatry."},{"key":"B2","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.jpsychires.2017.09.024","article-title":"Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: a randomized clinical trial demonstrating clinical utility","volume":"96","author":"Bradley","year":"2018","journal-title":"J. Psychiatr. Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1111\/j.1398-9995.2009.01973.x","article-title":"GradingGrading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions","volume":"64","author":"Brozek","year":"2009","journal-title":"Allergy"},{"key":"B4","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.jpsychires.2019.01.003","article-title":"Impact of pharmacogenomics in major depressive disorder in the GUIDED trial: a large, patient-and rater-blinded, randomized, controlled study","author":"Greden","year":"2019","journal-title":"J. Psych Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e172","DOI":"10.1038\/tp.2012.99","article-title":"Using a pharmacogenomic algorithm to guide the treatment of depression","volume":"2","author":"Hall-Flavin","year":"2012","journal-title":"Transl. Psychiatry."},{"key":"B6","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1097\/FPC.0b013e3283649b9a","article-title":"Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting","volume":"23","author":"Hall-Flavin","year":"2013","journal-title":"Pharmacogenet. Genomics."},{"key":"B7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1055\/s-0043-116492","article-title":"Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017","volume":"51","author":"Hiemke","year":"2018","journal-title":"Pharmacopsychiatry"},{"key":"B8","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1186\/s12888-017-1412-1","article-title":"Efficacy of prospective pharmacogenetic testing in the treatment of major depressive disorder: results of a randomized, double-blind clinical trial","volume":"17","author":"Perez","year":"2017","journal-title":"BMC Psychiatry."},{"key":"B9","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1503\/jpn.100059","article-title":"Pharmacogenetics of antidepressant response","volume":"36","author":"Porcelli","year":"2011","journal-title":"J. Psychiatry Neurosci."},{"key":"B10","volume-title":"Treatment of depression, a systematic review","year":"2004"},{"key":"B11","doi-asserted-by":"publisher","first-page":"150","DOI":"10.9758\/cpn.2015.13.2.150","article-title":"Improved antidepressant remission in major depression via a pharmacokinetic pathway polygene pharmacogenetic report","volume":"13","author":"Singh","year":"2015","journal-title":"Clin. Psychopharmacol. Neurosci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1038\/mp.2012.42","article-title":"Genetic variability of drug-metabolizing enzymes: the dual impact on psychiatric therapy and regulation of brain function","volume":"18","author":"Stingl","year":"2013","journal-title":"Mol. Psychiary."},{"key":"B12","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1038\/clpt.2011.34","article-title":"Pharmacogenetics: from bench to byte--an update of guidelines","volume":"89","author":"Swen","year":"2011","journal-title":"Clin. Pharmacol. Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"781175","DOI":"10.1038\/sj.clpt.6100507","article-title":"Pharmacogenetics: from bench to byte","volume":"8384","author":"Swen","year":"2008","journal-title":"Clin. Pharmacol. Thererratum Clin. Pharmacol. Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3389\/fpsyt.2020.00094","article-title":"Pharmacogenomics of antidepressants and antipsychotic treatment: how far have we got and where are we going?","volume":"11","author":"van Westrhenen","year":"2020","journal-title":"Front. Psychiatry."},{"key":"B15","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1146\/annurev.psych.55.090902.141950","article-title":"Schizophrenia: etiology and course","volume":"55","author":"Walker","year":"2004","journal-title":"Annu. Rev. Psychol."},{"key":"B16","first-page":"219","article-title":"A prospective, randomized, double-blind study assessing the clinical impact of integrated pharmacogenomic testing for major depressive disorder","volume":"16","author":"Winner","year":"2013","journal-title":"Discov. Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/cpt.690","article-title":"Worldwide distribution of cytochrome P450 alleles: a meta-analysis of population-scale sequencing projects","volume":"102","author":"Zhou","year":"2017","journal-title":"Clin. Pharmacol. Ther."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2021.640032\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T13:39:32Z","timestamp":1619703572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2021.640032\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":18,"alternative-id":["10.3389\/fphar.2021.640032"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2021.640032","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,12]]},"article-number":"640032"}}