Aug 2026· Psychiatry Research· Vol 365, pp.
117369
· 0 citations· 40 references
Medicine
TL;DR
PGx-guided individualized treatment has significant advantages for depression; this study offers evidence-based support for precision individualized antidepressant pharmacotherapy and assists clinical medication decision-making.
Abstract
Conventional antidepressant pharmacotherapy is limited by high interindividual variability, frequent adverse drug reactions, and unstable therapeutic efficacy. In recent years, pharmacogenomics (PGx) testing has emerged and increasingly become a core approach for individualized treatment. In this study, a total of 400 patients with depression were included and divided into the PGx-guided (PGx-g) group and the non-PGx-guided (NPGx-g) group. The genetically guided group received individualized dosing regimens formulated based on PGx results, while the NPGx-g group was prescribed medication regimens according to clinical guidelines and physician experience. The primary outcome measures included scores on the Hamilton Depression Scale (HAMD), incidence of adverse reactions, drug discontinuation rate, readmission rate, medication adherence, and scores on the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The PGx-g group was significantly superior to the NPGx-g group in terms of improvements in HAMD scores (P<0.05) , overall clinical response rate (92% vs. 74.5%, PFDR< 0.05), incidence of adverse reactions (6% vs. 13.5%, PFDR< 0.05), treatment discontinuation rate (6.53% vs. 14.21%, PFDR< 0.05), medication adherence, and quality of life. PGx-guided individualized treatment has significant advantages for depression; this study offers evidence-based support for precision individualized antidepressant pharmacotherapy and assists clinical medication decision-making.
PGx+GIT was not superior to GIT alone, possibly due to a ceiling effect of GIT, or PGx did not yield better results, according to a ceiling effect of GIT.
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The results indicate that TRD does not represent a single, unified PGx-predicted 'poor pharmacological responder' phenotype but instead reflects a biologically heterogeneous collection of distinct PGx profiles, and actionable PGx phenotypes are neither enriched in TRD nor associated with greater TRD severity.
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