Open-label pilot study of psychiatric pharmacogenetic testing in an adult psychiatric inpatient population

Abstract Introduction Treatment outcomes for depression and anxiety disorders remain suboptimal. Pharmacogenetic-guided medication treatment may be one way to improve outcomes. However, feasibility of pharmacogenetic testing in inpatient psychiatric settings has not been explored. This pilot study investigated the feasibility of collection and potential efficacy of pharmacogenetic testing three months after psychiatric hospitalization for severe depression and anxiety-related symptoms. Methods Participants (n = 75) in this open-labeled study were inpatients on a short-term acute care unit for severe depression and anxiety. Participants were assigned to control and experimental conditions. The experimental group completed a psychiatric pharmacogenetic assay while inpatient. Results were returned prior to discharge, allowing prescribers to adjust medication regimens as clinically indicated. The control group received pharmacogenetic results three months later. At admission and three months later, participants completed self-report measures to address psychiatric symptoms, quality of life, and satisfaction with the pharmacogenetic assay. Results Reductions on primary outcome measures were not significantly different between study groups. The experimental group did not report significantly greater reductions than the control group on primary study outcomes of anxiety, depression, frequency of medication changes following discharge or on some secondary study measures. Participants in the experimental group did report significantly greater reductions than controls on quality of life impairment (X2 = 8.51, p=.004) after corrections for multiple comparisons. Conclusions This open-label pilot study provides preliminary support for the feasibility of psychiatric pharmacogenetic testing in an inpatient setting. Future studies should investigate psychiatric pharmacogenetic testing efficacy in larger inpatient samples and account for medication changes resulting directly from test results.