Pharmacogenetics in psychiatry: some key clinical considerations

Psychiatric disorders affect about 1 billion people and cause 19% of disabilities. Despite the high number of psychotropic drugs available, there are still few objective criteria to personalize treatments based on the individual characteristics, and pharmacogenetics (PGx) is one of them. This review aimed to present the current clinical applications of PGx in psychiatry and to discuss some key points related to the use of PGx in psychiatric practice. PGx is a potentially very useful resource; however, it should be applied on the ground of a series of considerations, starting with physicians' training and patients' point of view, that are important and interconnected elements. Patients may have different opinions, perceptions and needs concerning their therapeutic plan, including the use of PGx; clinicians should be trained both on technical aspects and proper skills to communicate the pros and cons of PGx, to avoid worry or unrealistic expectations. PGx can have different applications and impact depending on the clinical setting it is applied to, e.g., primary care or specialist care. Another important consideration is the prescription of PGx in some groups of patients who can require specific care. In particular, the use of PGx to guide treatment prescription in children:adolescents and in the elderly is discussed. Finally, considerations on the integration of PGx in electronic health records and future research perspectives are presented.