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Personalized medicine; Pharmacogenomics; Antidepressants; Cyp2d6 polymorphism; Major depressive disorder; Drug metabolism; Treatment response; Genetic testing; Tailored therapy; Clinical outcomes

Introduction

Major depressive disorder (MDD) is a leading cause of disability worldwide, with many patients experiencing delayed or inadequate response to standard antidepressant therapy. Interindividual variability in drug metabolism, largely influenced by genetic polymorphisms in cytochrome P450 enzymes such as CYP2D6 and CYP2C19, significantly impacts treatment response and tolerability [1-5]. Pharmacogenomic profiling enables clinicians to identify these genetic differences and personalize antidepressant selection and dosing. This pilot study investigates the feasibility and clinical benefits of pharmacogenomics-guided antidepressant therapy in improving outcomes for patients with MDD [6-10].

Discussion

The study involved genotyping patients prior to initiating treatment, and antidepressants were selected or adjusted based on individual metabolic profiles. For example, poor CYP2D6 metabolizers were advised against medications like nortriptyline and fluoxetine, while ultra-rapid metabolizers received adjusted doses or alternative drugs. Clinical outcomes were measured using the Hamilton Depression Rating Scale (HAM-D) over an 8-week period. Patients receiving genotype-guided therapy showed faster symptom improvement, fewer side effects, and higher treatment adherence compared to controls. The results underscore the clinical utility of pharmacogenomic testing in psychiatry. However, the study also revealed barriers such as test cost, limited insurance coverage, and lack of clinician familiarity. Education and integration of decision-support tools can facilitate wider adoption. The study’s small sample size limits generalizability, but findings support further investigation in larger trials.

Conclusion

Pharmacogenomic profiling holds great promise for personalizing antidepressant therapy, reducing trial-and-error prescribing, and improving treatment outcomes in depression. As evidence grows, integrating genetic testing into psychiatric practice could revolutionize mental health care by aligning therapy with individual biology.

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