Clinical implications of pharmacogenetics in psychiatric treatment

Abstract

Tricyclic antidepressants have played leading roles in the psychiatric pharmacotherapy scene along the years, with amitriptyline credited in the management of depression, and progressively also in neuropathic pain. Exposure to amitriptyline and its metabolites is influenced by genetic polymorphisms of cytochrome P450 subfamily enzymes, particularly CYP2C19 and CYP2D6. Evaluating the impact of genotype-inferred variability on individual pharmacokinetics and corresponding outcomes, as may be moderated by co-medications and confounding host factors, should enable better informed use of this established drug. This research studied the intricate implications of pharmacogenetics in delivering precision medicine, through an investigative methodology that integrates regulatory, analytical (genetic and chemical), and clinical aspects, using amitriptyline as a case example.