Review article
Pharmacogenomics in Psychiatry
Maja Živković
Petra Sulić
Laura Tomić
Alma Mihaljević-Peleš
Nada Božina
Abstract
Pharmacogenomics (PGx) in psychiatry is a clinically useful tool for personalized treatment and should be purposefully incorporated into psychotropic drug selection and dosing, alongside appropriate clinical assessment, particularly in cases of adverse effects, non-response, and complex polypharmacy. The best developed and most clearly guideline-defined area of psychiatric pharmacogenomics currently relates to pharmacokinetic variants in cytochrome P450 genes, especially CYP2D6 and CYP2C19 (selectively also CYP2B6) for antidepressants, while clinically relevant recommendations also exist for antipsychotics, primarily involving CYP2D6, CYP3A4, and CYP1A2. Randomized studies in depression most consistently show improvements in process outcomes (e.g., more rational medication selection in relation to predicted gene–drug interactions), whereas effects on remission are modest on average. Reviews and expert statements emphasize selective use, reliance on transparent guidelines, and caution when interpreting commercial panels that use proprietary algorithms. Polygenic pharmacogenomic scores and the integration of DNA/RNA biomarkers are promising future directions, but they are still insufficiently validated for routine clinical use.
Keywords
Hrčak ID:
349490
URI
Publication date:
10.7.2026.
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