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Case 17 - “I Feel Very Lonely”

Depression/Psychogenomic Testing

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

A major influence on positive or negative therapeutic responses to a medication is the drug’s metabolism in a given individual. The metabolism of pharmaceuticals is influenced by age-related factors. Lithium, valproic acid, and carbemazepine levels are still important to obtain periodically when these drugs are used in the management of bipolar disorder and some other psychiatric and neurologic conditions. The metabolism and serum concentrations of medications do not always correlate well with clinical response. At this time pharmacogenetic information used to guide antidepressant therapy does not consistently show improved outcomes. Some studies show improved outcomes and some show no difference in outcomes.

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Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 83 - 87
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163 (11), 19051917.CrossRefGoogle ScholarPubMed
Mrazek, D. A., Hornberger, J. C., Altar, C. A., & Degtiar, I. (2014). A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996–2013. Psychiatric services, 65 (8), 977987.CrossRefGoogle ScholarPubMed
Hampton, L. M., Daubresse, M., Chang, H. Y., Alexander, G. C., & Budnitz, D. S. (2014). Emergency department visits by adults for psychiatric medication adverse events. JAMA Psychiatry, 71 (9), 10061014.CrossRefGoogle ScholarPubMed

Further Reading

Bousman, C., Al Maruf, A., & Müller, D. J. (2019). Towards the integration of pharmacogenetics in psychiatry: A minimum, evidence-based genetic testing panel. Current Opinion in Psychiatry, 32 (1), 715.CrossRefGoogle ScholarPubMed
Bradley, P., Shiekh, M., Mehra, V., Vrbicky, K., Layle, S., Olson, M. C., & Lukowiak, A. A. (2018). Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: A randomized clinical trial demonstrating clinical utility. Journal of Psychiatric Research, 96, 100107.CrossRefGoogle ScholarPubMed
Corponi, F., Fabbri, C., & Serretti, A. (2018). Pharmacogenetics in psychiatry. Advances in Pharmacology, 83, 297331.CrossRefGoogle ScholarPubMed
Florio, V., Porcelli, S., Saria, A., Serretti, A., & Conca, A. (2017). Escitalopram plasma levels and antidepressant response. European Neuropsychopharmacology, 27 (9), 940944.CrossRefGoogle ScholarPubMed
Hicks, J. K., Sangkuhl, K., Swen, J. J., Ellingrod, V. L., Müller, D. J., Shimoda, K., & Stingl, J. C. (2017). Clinical pharmacogenetics implementation consortium guideline (CPIC®) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clinical Pharmacology and Therapeutics, 102 (1), 37.CrossRefGoogle ScholarPubMed
Maciel, A., Cullors, A., Lukowiak, A. A., & Garces, J. (2018). Estimating cost savings of pharmacogenetic testing for depression in real-world clinical settings. Neuropsychiatric Disease and Treatment, 14, 225230.CrossRefGoogle ScholarPubMed

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  • “I Feel Very Lonely”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.018
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Save book to Dropbox

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  • “I Feel Very Lonely”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.018
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “I Feel Very Lonely”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.018
Available formats
×