Genetic Testing in Psychiatry
Nine point-of-care chapters on what a pharmacogenomic result can and cannot do — whether to order the test, how to read a report a patient hands you, when a metabolizer call changes a dose or a drug, and which results look actionable but are not — closing with a one-screen drug–gene action grid.
The full course is complete: nine chapters in four sections, plus the closing action grid. Chapters 1 and 8 are free to read.
What this course is for
Pharmacogenomic testing in psychiatry is marketed as a way to pick the right antidepressant. It mostly cannot do that. What a result can do is narrower and more useful: for specific drug–gene pairs, it changes a dose or steers you off a drug, and for a few drugs a genetic test is a safety step before the first dose. This course is built to tell those situations apart — and to recognize the results that look decisive but should change nothing.
Every chapter is built around the decision in front of you: order the test or not, act on the report or not, lower the dose, switch, or ignore the result. Each recommendation names the body behind it — CPIC, DPWG, the specific FDA label, or the FDA’s own pharmacogenetic table — because they often disagree, and the disagreement changes what you do. Where a gene has no actionable use, the course says so plainly rather than leaving the question open.
Bedside panel first
Each chapter opens with a two-minute panel: do now, do not, the questions to ask, a red / amber / green triage, and the EMR note. The detailed chapter follows below.
Attribution you can cite
Every recommendation is credited to a named source — CPIC, DPWG, a specific FDA label, or the FDA table — kept separate rather than blended, so you know exactly whose advice you are following.
Built to use, not to read
Counselling scripts written for the visit and copy-paste EMR notes in every chapter, plus a one-screen action grid that puts every drug–gene pair in the course on a single page.
The “should I test?” triage, exactly as it appears in the chapter
- Carbamazepine in a patient with ancestry in an at-risk population: the label’s boxed warning says to screen for HLA-B*15:02 before starting
- Carbamazepine in a patient known to carry HLA-A*31:01: the US label warns of hypersensitivity reactions; weigh the risks and benefits before prescribing
- Oxcarbazepine in the same at-risk patients: HLA-B*15:02 testing should be considered before starting
- Valproate with a family history or features suggesting a POLG-related mitochondrial disorder: the label calls for POLG testing, and valproate is contraindicated in known POLG disorders and in children under 2 suspected of one
- You are dosing a current drug, or choosing a new one, with a CPIC, DPWG or FDA label recommendation for a gene the test covers
- Side effects at low doses, or no response at an adequate dose and duration, on drugs with such recommendations
- The patient is likely to need several drugs with such recommendations over time (pre-emptive testing)
The patient is doing well on a tolerated drug, the question is which drug will work, or an adequate result already exists. Explain what a result can and cannot do, and record the discussion.
Every chapter opens with a bedside panel like this one — what to do now, what not to do, the questions to ask and the triage — before the detailed chapter begins. Chapter 1 is free to read.
Covered elsewhere in the Academy
Pregnancy and lactation prescribing is covered in the Perinatal Psychopharmacology Series; this course covers only how pregnancy changes enzyme activity and drug exposure around a genotype result. The adverse effects of the mood stabilizers named in the safety-testing chapter are covered in Managing Mood Stabilizer Adverse Events.
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One membership covers this course and the entire Academy library — psychopharmacology lessons, case discussions and clinical pearls, with new content added monthly.
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Apply(A) Deciding whether to test
(B) Reading what comes back
(C) Acting on the enzymes
(D) What not to act on
(E) Closing reference
