Archive \ Volume.16 2025 Issue 2

From DNA to Doses: How Pharmacogenomics Transforms Depression Care in Community Pharmacy

Momin Shabana*✉ , Nusrath Fatima , T. Kusuma Teja , Umar Zeshan

  1. Department of Pharmacy Practice, St. Pauls College of Pharmacy, Affiliated to Osmania University, Hyderabad, India.


Abstract

Pharmacogenomic testing can identify these genetic variations, allowing healthcare providers to adjust drug selection and dosage accordingly. These tests typically involve a simple cheek swab or saliva sample, which is then analysed to identify specific genetic variations that affect drug metabolism and response. Cytochrome P450 (CYP450) enzyme is responsible for the metabolism of many antidepressants. CYP2D6 and CYP2C19 may cause variations in how drugs are metabolized. A neurotransmitter involved in mood modulation, the serotonin transporter gene (SLC6A4), affects serotonin reuptake. Val66Met, a gene for the brain-derived neurotrophic factor (BDNF), has been connected to variations in how people react to antidepressants. Effective implementation of pharmacogenomics in clinical practice requires supportive policies that address issues such as reimbursement, education, and privacy. Among the pharmacist's duties are analyzing genetic information, working with medical professionals, offering patient counseling, and incorporating pharmacogenomics into the administration of drug therapy. Patients with severe depressive disorders had much better results when a combinatorial pharmacogenomic test was used to detect and target those with expected gene-drug interactions. Utilizing a structured data framework of genetic, phenotypic, and environmental characteristics, personalized medicine should offer the healthcare system practical methods to maximize the efficacy of certain treatments.


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Vancouver
Shabana M, Fatima N, Teja TK, Zeshan U. From DNA to Doses: How Pharmacogenomics Transforms Depression Care in Community Pharmacy. Arch Pharm Pract. 2025;16(2):12-8. https://doi.org/10.51847/Si19CmLJuz
APA
Shabana, M., Fatima, N., Teja, T. K., & Zeshan, U. (2025). From DNA to Doses: How Pharmacogenomics Transforms Depression Care in Community Pharmacy. Archives of Pharmacy Practice, 16(2), 12-18. https://doi.org/10.51847/Si19CmLJuz

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References
  1. Brockmöller J, Tzvetkov MV. Pharmacogenetics: data, concepts and tools to improve drug discovery and drug treatment. Eur J Clin Pharmacol. 2008;64(2):133-57.
  2. Lam RW. Depression. Oxford University Press; 2018.
  3. Hayashi M, Hamdy DA, Mahmoud SH. Applications for pharmacogenomics in pharmacy practice: a scoping review. Res Soc Adm Pharm. 2022;18(7):3094-118.
  4. Saunders H, Harris D, Chirilă RM. Pharmacogenomics: introduction and use in clinical practice. Rom J Intern Med. 2020;58(2):69-74.
  5. Mrazek DA, Hornberger JC, Altar CA, Degtiar I. A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996–2013. Psychiatr Serv. 2014;65(8):977-87.
  6. Manchia M, Pisanu C, Squassina A, Carpiniello B. Challenges and future prospects of precision medicine in psychiatry. Pharmacogenomics Pers Med. 2020;13:127-40.
  7. Risch N, Herrell R, Lehner T, Liang KY, Eaves L, Hoh J, et al. Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: a meta-analysis. Jama. 2009;301(23):2462-71.
  8. Turpeinen M, Zanger UM. Cytochrome P450 2B6: function, genetics, and clinical relevance. Drug Metabol Drug Interact. 2012;27(4):185-97.
  9. Magalhães PR. Pharmacometric evaluation of the clinical impact of genetic polymorphisms of the cytochrome P450 and P-Glycoprotein in the Pharmacokinetics and Pharmacodynamics of Antidepressant Drugs: Fluoxetine, Paroxetine and Venlafaxine [dissertation]. Coimbra: Universidade de Coimbra; 00500.
  10. Shields MR. Pharmacogenomics in Pharmacy Practice.
  11. Allen JD, Pittenger AL, Bishop JR. A scoping review of attitudes and experiences with pharmacogenomic testing among patients and the general public: implications for patient counseling. J Pers Med. 2022;12(3):425.
  12. Waldman L, Shuman C, Cohn I, Kaiser A, Chitayat D, Wasim S, et al. Perplexed by PGx? Exploring the impact of pharmacogenomic results on medical management, disclosures and patient behavior. Pharmacogenomics. 2019;20(5):319-29.
  13. Bryant B. Apprenticeship to degree: the co-evolution of twentieth-century pharmacy practice and education from a Queensland and regional perspective [dissertation]. Rockhampton (AU): CQUniversity.
  14. Balogun OD, Ayo-Farai O, Ogundairo O, Maduka CP, Okongwu CC, Babarinde AO, et al. The role of pharmacists in personalised medicine: a review of integrating pharmacogenomics into clinical practice. Int Med Sci Res J. 2024;4(1):19-36.
  15. Bishop JR, Schneiderhan ME, Butler T, Carpentier RM, Heins KR, Formea CM. Pharmacogenomics to support mental health medication therapy management: Clinical practice considerations and a conceptual framework to enhance patient care. J Am Coll Clin Pharm. 2024;7(2):160-70.
  16. Davis EA. Cipher of bad souls: an ethnography of madness and responsibility in Greek Thrace. Berkeley (CA): University of California, Berkeley; 2005.
  17. Dragomani R. No child left behind: a quality improvement clinical implementation to improve the treatment outcomes, quality of care, and quality of life for school-aged children with attention-deficit/hyperactivity disorder at a rural primary care practice [dissertation]. Chapel Hill (NC): The University of North Carolina at Chapel Hill.
  18. Hansen JM, Nørgaard JD, Sporrong SK. A systematic review of pharmacogenetic testing in primary care: attitudes of patients, general practitioners, and pharmacists. Res Soc Adm Pharm. 2022;18(8):3230-8.
  19. McDermott JH, Wright S, Sharma V, Newman WG, Payne K, Wilson P. Characterizing pharmacogenetic programs using the consolidated framework for implementation research: a structured scoping review. Front Med. 2022;9:945352.
  20. Kim JA, Ceccarelli R, Lu CY. Pharmacogenomic biomarkers in US FDA-approved drug labels (2000–2020). J Pers Med. 2021;11(3):179.
  21. Kirchheiner J, Fuhr U, Brockmöller J. Pharmacogenetics-based therapeutic recommendations—ready for clinical practice? Nat Rev Drug Discov. 2005;4(8):639-47.
  22. Bostwick JM. A generalist's guide to treating patients with depression with an emphasis on using side effects to tailor antidepressant therapy. InMayo Clinic Proceedings 2010 Jun 1 (Vol. 85, No. 6, pp. 538-550). Elsevier.
  23. Simmons MB, Hetrick SE, Jorm AF. Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences. BMC Psychiatry. 2013;13:1-6.
  24. Khan PA. Personalized medicine: optimizing treatment with the right drug, for the right patient, and at the right dose through pharmacogenomics. Pristyn Research Solutions.
  25. Fleming JM. Pharmacogenomics in primary care: barriers to implementation [DNP scholarly project]. Lynchburg (VA): Liberty University; 2020.
  26. Klein ME, Parvez MM, Shin JG. Clinical implementation of pharmacogenomics for personalized precision medicine: barriers and solutions. J Pharm Sci. 2017;106(9):2368-79.
  27. Clayton EW, Evans BJ, Hazel JW, Rothstein MA. The law of genetic privacy: applications, implications, and limitations. J Law Biosci. 2019;6(1):1-36.
  28. Moyer AM, Caraballo PJ. The challenges of implementing pharmacogenomic testing in the clinic. Expert Rev Pharmacoecon Outcomes Res. 2017;17(6):567-77.
  29. Amare AT, Schubert KO, Baune BT. Pharmacogenomics in the treatment of mood disorders: strategies and opportunities for personalized psychiatry. EPMA J. 2017;8:211-27.
  30. Xu L, Li L, Wang Q, Pan B, Zheng L, Lin Z. Effect of pharmacogenomic testing on the clinical treatment of patients with depressive disorder: a randomized clinical trial. J Affect Disord. 2024;359:117-24.
  31. Miller JJ, Fletcher K, Kabat-Zinn J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995;17(3):192-200.
  32. Tucker L. Pharmacogenomics: a primer for policymakers.
  33. Ferwerda ME, Wright JA, El Melik RM, Swen JJ, Houwink EJ. Pharmacogenetic educational needs and the role of pharmacogenetics in primary care: a focus group study with multiple perspectives. Front Pharmacol. 2024;15:1404370.
  34. Carvalho Henriques B. Pharmacogenomics for psychiatry: focusing on drug metabolizing enzymes and transporters, with validated methodology for CYP2D6 and CYP2C19 Including for a Novel Sub-Haplotype [master’s thesis]. Edmonton (AB): University of Alberta, Department of Psychiatry.
  35. Rantucci MJ. Pharmacists talking with patients: a guide to patient counseling. Philadelphia (PA): Lippincott Williams & Wilkins; 2007.
  36. McKittrick A. A review of the current state of clinical pharmacogenomic testing: an examination of existing and potential roles for genetic counselors and pharmacists. Bronxville (NY): Sarah Lawrence College; 2014.
  37. Hess GP, Fonseca E, Scott R, Fagerness J. Pharmacogenomic and pharmacogenetic-guided therapy as a tool in precision medicine: current state and factors impacting acceptance by stakeholders. Genet Res. 2015;97:e13.
  38. Roberts B, Cooper Z, Lu S, Stanley S, Majda BT, Collins KR, et al. Utility of pharmacogenetic testing to optimise antidepressant pharmacotherapy in youth: a narrative literature review. Front Pharmacol. 2023;14:1267294.
  39. Taherdoost H, Ghofrani A. AI and the evolution of personalized medicine in pharmacogenomics. Intell Pharm. 2024.

 

 

 


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