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The utility of genetic testing in depression is still in question (NEJM JW Psychiatry Oct 2017). In a multisite study funded by the manufacturer of the GeneSite Psychotropic test, researchers (several of whom had been employees), examined the performance of this test in 1541 patients with moderate-to-severe MDD and inadequate response to at least one documented psychotropic.
The test genotypes 59 alleles across 6 pharmacokinetic and 2 pharmacodynamic genes and then weights the influence of each genotype on likely response to 38 psychotropic medications. The participants were randomized to testing-guided care (clinicians had access to the guided-care patients' test reports before medication selection) or treatment as usual. Patients and rater…