A New Intervention for Implementation of Pharmacogenetics in Psychiatry

Summary

Medication for mental health problems do not work for all patients, and often come with unwanted side effects. Recent research has suggested that whether a medication provides benefits to mental health can depend on an individual’s genes, because genes can influence the way in which medications are broken down in the body. This study aims to test whether prescribing medication based on genetic testing can improve mental health symptoms and reduce side effects.

The study will recruit adults (aged 18 to 65 years) with depression or anxiety who have not felt much benefit from their current medication. All participants will then be prescribed a recommended medication for their mental health problem: sertraline or escitalopram for depression or anxiety. These are recommended, routinely prescribed, and safe medications.

Participants will be put into one of two groups at random. One group will take their medication based on standard dose guidelines (treatment as usual). The other group will take their medication based on a new dosage guideline, which recommends people take different amounts of the medication based on their genes. The doctor will tell each participant how much medication to take.

Each participant will take part for 6 months. During this time there will be five visits to the hospital to check mental and physical health symptoms. A blood sample will be taken at the first and third visit. Participants will also download an app during the study which monitors their phone usage and behaviour. At the end of the study, we will compare how many participants have recovered in each group.