Retrospective Analysis of Outcomes With a Pharmacogenomic Algorithm

A Retrospective Analysis of Outcomes in Outpatients With Major Depressive Disorder (MDD) in a Staff Model HMO: Pharmacogenetic Algorithm for Psychotropic Pharmacotherapeutic Applications

Antidepressants are among the most widely prescribed medications, yet only 35-45% of patients achieve remission following an initial antidepressant trial. The financial burden of treatment failures in direct treatment costs, disability, decreased productivity, and missed work may in part derive from a mismatch between optimal, and actual, medications prescribed. The present one year retrospective study seeks to evaluate the indirect and direct healthcare costs for 96 patients with a DSM-IV-TR depressive or anxiety disorder, in relation to an interpretive reporting system designed to predict antidepressant responses based on DNA variations in cytochrome P450 genes (CYP2D6, CYP2C19, CYP1A2), the serotonin transporter gene (SLC6A4), and the serotonin 2A receptor (5HTR2A) genes.

Inclusion Criteria:

• Major Depressive Disorder
• Dysthymic Disorder
• Depressive Disorder NOS
• Obsessive Compulsive Disorder (OCD)
• Generalized Anxiety Disorder
• Panic Disorder
• Anxiety Disorder NOS
• Post-Traumatic Stress Disorder (PTSD)
• Social Phobia

Exclusion Criteria:

• Bipolar Disorder
• Schizophrenia
• Schizoaffective Disorder
• Previous pharmacogenomic testing