Journal of Neural Transmission

, Volume 126, Issue 1, pp 95–99 | Cite as

Patient characteristics driving clinical utility in psychiatric pharmacogenetics: a reanalysis from the AB-GEN multicentric trial

  • J. M. Menchón
  • J. Espadaler
  • M. Tuson
  • J. Saiz-Ruiz
  • J. Bobes
  • E. Vieta
  • E. Álvarez
  • V. PérezEmail author
Psychiatry and Preclinical Psychiatric Studies - Original Article


Clinical utility of commercial multi-gene pharmacogenetic tests in depression is starting to be studied with some promising results on efficacy and tolerability. Among the next steps is the definition of the patient profile that is most likely to benefit from testing. Here we present a reanalysis of data from the AB-GEN randomized clinical trial showing that clinical utility of pharmacogenetic testing can be markedly influenced by patient characteristics such as age, baseline severity and duration of current depressive episode.

Trial registration NCT02529462.


Depression Pharmacogenetics Precision medicine Antidepressant response Randomized clinical trial Baseline severity 



Authors wish to thank Trialance SCCP (Barcelona, Spain) for providing statistical services, and the AB-GEN Collaborative Group.

Compliance with ethical standards

Conflict of interest

JE and MT are full-time employees of AB-Biotics SA, the company that developed the Neuropharmagen test used in this study. VP, JM and EV have served as consultants for AB-Biotics SA.


  1. Altar CA, Carhart J, Allen JD, Hall-Flavin D, Winner J, Dechairo B (2015) Clinical utility of combinatorial pharmacogenomics-guided antidepressant therapy: evidence from three clinical studies. Mol Neuropsychiatry 1(3):145–155. CrossRefGoogle Scholar
  2. Bousman CA, Hopwood M (2016) Commercial pharmacogenetic-based decision-support tools in psychiatry. Lancet Psychiatry 3(6):585–590. CrossRefGoogle Scholar
  3. Bradley P, Shiekh M, Mehra V, Vrbicky K, Layle S, Olson MC, Maciel A, Cullors A, Garces JA, Lukowiak AA (2018) Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: a randomized clinical trial demonstrating clinical utility. J Psychiatr Res 96:100–107. CrossRefGoogle Scholar
  4. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373(9665):746–758. CrossRefGoogle Scholar
  5. Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J (2010) Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA J Am Med Assoc 303(1):47–53. CrossRefGoogle Scholar
  6. Guy W (ed) (1976) EC-DEU assessment manual for psychopharmacology—Revised (DHEW Publ No ADM 76–338). Department of Health, Education, and Welfare Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs, Rockville, MD, U.S. pp 218–222Google Scholar
  7. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23(1):56CrossRefGoogle Scholar
  8. Perez V, Salavert A, Espadaler J, Tuson M, Saiz-Ruiz J, Saez-Navarro C, Bobes J, Baca-Garcia E, Vieta E, Olivares JM, Rodriguez-Jimenez R, Villagran JM, Gascon J, Canete-Crespillo J, Sole M, Saiz PA, Ibanez A, de Diego-Adelino J, Menchon JM (2017) Efficacy of prospective pharmacogenetic testing in the treatment of major depressive disorder: results of a randomized, double-blind clinical trial. BMC Psychiatry 17(1):250. CrossRefGoogle Scholar
  9. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackeim HA, Kupfer DJ, Luther J, Fava M (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 163(11):1905–1917. CrossRefGoogle Scholar
  10. Sheehan DV, Keene MS, Eaddy M, Krulewicz S, Kraus JE, Carpenter DJ (2008) Differences in medication adherence and healthcare resource utilization patterns: older versus newer antidepressant agents in patients with depression and/or anxiety disorders. CNS Drugs 22(11):963–973CrossRefGoogle Scholar
  11. Singh AB (2015) Improved antidepressant remission in major depression via a pharmacokinetic pathway polygene pharmacogenetic report. Clin Psychopharmacol Neurosci Off Sci J Korean Coll Neuropsychopharmacol 13(2):150–156. CrossRefGoogle Scholar
  12. Singh AB, Bousman CA, Ng C, Berk M (2014) Antidepressant pharmacogenetics. Curr Opin Psychiatry 27(1):43–51. CrossRefGoogle Scholar
  13. Tansey KE, Guipponi M, Hu X, Domenici E, Lewis G, Malafosse A, Wendland JR, Lewis CM, McGuffin P, Uher R (2013) Contribution of common genetic variants to antidepressant response. Biol Psychiatry 73(7):679–682. CrossRefGoogle Scholar
  14. Tedeschini E, Levkovitz Y, Iovieno N, Ameral VE, Nelson JC, Papakostas GI (2011) Efficacy of antidepressants for late-life depression: a meta-analysis and meta-regression of placebo-controlled randomized trials. J Clin Psychiatry 72(12):1660–1668. CrossRefGoogle Scholar
  15. Tham A, Jonsson U, Andersson G, Soderlund A, Allard P, Bertilsson G (2016) Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder—a systematic review and a meta-analysis. J Affect Disord 205:1–12. CrossRefGoogle Scholar
  16. Wisniewski SR, Rush AJ, Nierenberg AA, Gaynes BN, Warden D, Luther JF, McGrath PJ, Lavori PW, Thase ME, Fava M, Trivedi MH (2009) Can phase III trial results of antidepressant medications be generalized to clinical practice? A STAR*D report. Am J Psychiatry 166(5):599–607. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • J. M. Menchón
    • 1
    • 2
    • 3
  • J. Espadaler
    • 4
  • M. Tuson
    • 4
  • J. Saiz-Ruiz
    • 1
    • 5
  • J. Bobes
    • 1
    • 6
    • 7
  • E. Vieta
    • 1
    • 8
    • 9
  • E. Álvarez
    • 1
    • 10
    • 11
  • V. Pérez
    • 1
    • 12
    Email author
  1. 1.Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)MadridSpain
  2. 2.Departament de PsiquiatriaHospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
  3. 3.Departament de Ciències Clíniques, Facultat de MedicinaUniversitat de BarcelonaBarcelonaSpain
  4. 4.AB-Biotics SABarcelonaSpain
  5. 5.Departamento de Psiquiatría, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y CajalUniversidad de AlcaláMadridSpain
  6. 6.Área de Psiquiatría, Facultad de MedicinaUniversidad de OviedoOviedoSpain
  7. 7.Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA)OviedoSpain
  8. 8.Institut Clínic de Neurociències, Hospital Clínic de BarcelonaUniversitat de BarcelonaBarcelonaSpain
  9. 9.Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  10. 10.Servei de PsiquiatriaHospital de la Santa Creu i Sant PauBarcelonaSpain
  11. 11.Institut d’Investigació Biomèdica Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain
  12. 12.Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del MarUniversitat Autònoma de BarcelonaBarcelonaSpain

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