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Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report

In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine...

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Autores principales: Stäuble, Céline K., Lampert, Markus L., Mikoteit, Thorsten, Hatzinger, Martin, Hersberger, Kurt E., Meyer zu Schwabedissen, Henriette E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307172/
https://www.ncbi.nlm.nih.gov/pubmed/34357045
http://dx.doi.org/10.3390/life11070673
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author Stäuble, Céline K.
Lampert, Markus L.
Mikoteit, Thorsten
Hatzinger, Martin
Hersberger, Kurt E.
Meyer zu Schwabedissen, Henriette E.
author_facet Stäuble, Céline K.
Lampert, Markus L.
Mikoteit, Thorsten
Hatzinger, Martin
Hersberger, Kurt E.
Meyer zu Schwabedissen, Henriette E.
author_sort Stäuble, Céline K.
collection PubMed
description In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued due to subjective gastrointestinal intolerance. Due to the worsening of the depression after the failed treatment attempts, admission to our clinic became necessary. Herein, owing to the collaboration of psychiatrists with clinical pharmacists, individualized incorporation of pharmacogenetic data into the process of antidepressant selection was enabled. We identified vortioxetine as a suitable therapeutic, namely for being most likely pharmacokinetically unaffected as predicted by pharmacogenetic panel testing and taking into account the current comedication, as well as for its favorable action profile. Herein, our collaborative effort proved to be successful and resulted in the patient’s depression remission and clinic discharge with the interprofessionally selected pharmacotherapy. This exemplary case not only highlights the potential benefits and challenges of pre-emptive pharmacogenetic testing in antidepressant prescription, but also proposes an approach on how to put pharmacogenetics into practice.
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spelling pubmed-83071722021-07-25 Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report Stäuble, Céline K. Lampert, Markus L. Mikoteit, Thorsten Hatzinger, Martin Hersberger, Kurt E. Meyer zu Schwabedissen, Henriette E. Life (Basel) Case Report In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued due to subjective gastrointestinal intolerance. Due to the worsening of the depression after the failed treatment attempts, admission to our clinic became necessary. Herein, owing to the collaboration of psychiatrists with clinical pharmacists, individualized incorporation of pharmacogenetic data into the process of antidepressant selection was enabled. We identified vortioxetine as a suitable therapeutic, namely for being most likely pharmacokinetically unaffected as predicted by pharmacogenetic panel testing and taking into account the current comedication, as well as for its favorable action profile. Herein, our collaborative effort proved to be successful and resulted in the patient’s depression remission and clinic discharge with the interprofessionally selected pharmacotherapy. This exemplary case not only highlights the potential benefits and challenges of pre-emptive pharmacogenetic testing in antidepressant prescription, but also proposes an approach on how to put pharmacogenetics into practice. MDPI 2021-07-09 /pmc/articles/PMC8307172/ /pubmed/34357045 http://dx.doi.org/10.3390/life11070673 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Stäuble, Céline K.
Lampert, Markus L.
Mikoteit, Thorsten
Hatzinger, Martin
Hersberger, Kurt E.
Meyer zu Schwabedissen, Henriette E.
Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title_full Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title_fullStr Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title_full_unstemmed Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title_short Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report
title_sort pharmacogenetic-guided antidepressant selection as an opportunity for interprofessional collaboration: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307172/
https://www.ncbi.nlm.nih.gov/pubmed/34357045
http://dx.doi.org/10.3390/life11070673
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