Clinical implementation of pre-emptive pharmacogenomics in patients with anxiety disorders

Anxiety disorder is a typically chronic psychiatric condition with relapsing phases, affecting millions of individuals globally. Medication and psychotherapy are the primary interventions that can alleviate the symptoms in the short term. However, considerable interindividual variability in drug treatment response is observed, which can be attributed to genetic factors, mainly related to CYP2D6 and CYP2C19 genetic variants affecting antidepressant pharmacokinetics. Here we present our findings from the first and largest prospective clinical study focusing exclusively on outpatient adult anxiety patients, following the ICD-10 definitions. Our data indicate a lower incidence of psychiatric adverse drug reactions in the pharmacogenomics (PGx)-guided arm compared with the control arm. Furthermore, no hospitalizations were reported for the PGx-guided arm, unlike the control arm. In addition, participants in the control arm received more concomitant medications in total compared with the PGx-guided arm (P = 0.047). Our findings demonstrate that genome-guided therapeutics may substantially benefit anxiety patients and should be considered in routine clinical practice. In this study, Pandi and colleagues analyze the relevance of pharmacogenomic testing in the occurrence of adverse drug reactions in patients with a diagnosis of anxiety disorders from the PREPARE study.