{"doi":"10.1176/appi.focus.19107","title":"Combinatorial Pharmacogenomic Testing Improves Outcomes for Older Adults With Depression","abstract":"Objective: Evaluate the clinical utility of combinatorial pharmacogenomic testing for informing medication selection among older adults who have experienced antidepressant medication failure for major depressive disorder (MDD). Design: Post hoc analysis of data from a blinded, randomized controlled trial comparing two active treatment arms. Setting: Psychiatry specialty and primary care clinics across 60 U.S. community and academic sites. Participants: Adults age 65 years or older at baseline (n = 206), diagnosed with MDD and inadequate response to at least one medication on the combinatorial pharmacogenomic test report during the current depressive episode. Intervention: Combinatorial pharmacogenomic testing to inform medication selection (guided-care), compared with treatment as usual (TAU). Outcomes: Mean percent symptom improvement, response rate, and remission rate at week 8, measured using the 17-item Hamilton Depression Rating Scale; medication switching; and comorbidity moderator analysis. Results: At week 8, symptom improvement was not significantly different for guided-care than for TAU (A = 8.1%, t=1.64, df= 187; p = 0.102); however, guided-care showed significantly improved response (A = 13.6%, t = 2.16, df= 187; p = 0.032) and remission (A = 12.7%, t = 2.49, df= 189; p = 0.014) relative to TAU. By week 8, more than twice as many patients in guided-care than in TAU were on medications predicted to have no gene-drug interactions (x = 19.3, df=2;p <0.001). Outcomes in the guided-care arm showed consistent improvement through the end of the open-design 24-week trial, indicating durability of the effect. Differences in outcomes between arms were not significantly impacted by comorbidities. Conclusions: Combinatorial pharmacogenomic test-informed medication selection improved outcomes over TAU among older adults with depression. (Reprinted with permission from Am J Geriatr Psychiatry 2020; 28:933–945)","journal":"FOCUS The Journal of Lifelong Learning in Psychiatry","year":2021,"id":211635,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9488,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":374310,"name":"Sagar V. Parikh","orcid":"0000-0003-4817-3042","position":1,"is_corresponding":false},{"id":486098,"name":"Sara L. Weisenbach","orcid":"0000-0002-5330-4038","position":2,"is_corresponding":false},{"id":409581,"name":"Olusola Ajilore","orcid":"0000-0003-0737-0437","position":3,"is_corresponding":false},{"id":486099,"name":"Ipsit V. Vahia","orcid":"0000-0002-0282-640X","position":4,"is_corresponding":false},{"id":374309,"name":"Anthony J. Rothschild","orcid":"0000-0002-0902-5349","position":5,"is_corresponding":false},{"id":374312,"name":"Michael E. Thase","orcid":"0000-0002-6403-0861","position":6,"is_corresponding":false},{"id":58339,"name":"Boadie W. Dunlop","orcid":"0000-0002-4653-0483","position":7,"is_corresponding":false},{"id":375392,"name":"Charles DeBattista","orcid":null,"position":8,"is_corresponding":false},{"id":486100,"name":"Charles R. Conway","orcid":"0000-0001-6849-9416","position":9,"is_corresponding":false},{"id":623461,"name":"Richard C. Shelton","orcid":"0000-0003-4054-9906","position":10,"is_corresponding":false},{"id":374315,"name":"Matthew Macaluso","orcid":"0000-0001-6856-6236","position":11,"is_corresponding":false},{"id":486101,"name":"James Li","orcid":"0000-0002-2180-3780","position":12,"is_corresponding":false},{"id":487386,"name":"Paul Traxler","orcid":null,"position":13,"is_corresponding":false},{"id":486102,"name":"Jennifer Logan","orcid":"0000-0003-2658-991X","position":14,"is_corresponding":false},{"id":486103,"name":"Lisa Brown","orcid":"0000-0002-7719-6596","position":15,"is_corresponding":false},{"id":487387,"name":"Bryan Dechairo","orcid":null,"position":16,"is_corresponding":false},{"id":375396,"name":"John F. Greden","orcid":null,"position":17,"is_corresponding":false},{"id":375393,"name":"Brent P. Forester","orcid":null,"position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T23:52:20.112538Z","pmid":"34483773","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}