International Society of Psychiatric Genetics (ISPG) updated their guidelines on the use of genetic testing in psychiatric practice. Here is a summary of these recommendations:
(a) Pharmacogenetic testing should be viewed as a decision-support tool to assist in thoughtful implementation of good clinical care.
(b) They recommend HLA-A and HLA-B testing prior to use of carbamazepine and oxcarbazepine.
(c) Genetic information for CYP2C19 and CYP2D6 would likely be most beneficial for individuals who have experienced an inadequate response or adverse reaction to a previous antidepressant or antipsychotic trial.
(d) Evidence to support widespread use of other pharmacogenetic tests at this time is still inconclusive, but when pharmacogenetic testing results are already available, providers are encouraged to integrate this information into their medication selection and dosing decisions.
(e) Common genetic variants alone are not sufficient to cause psychiatric disorders such as depression, bipolar disorder, substance dependence, or schizophrenia.
(f) Identification of known pathogenic variants may help diagnose rare conditions that have important medical and psychiatric implications for individual patients and may inform family counseling.
(g) Copy Number Variants (CNV) testing may also prove useful for persons requesting counseling on familial risk. While the Committee did not reach consensus on widespread use of CNV testing in adult-onset disorders, most agreed that such tests may have value in cases that present atypically or in the context of intellectual disability, autism spectrum disorder, learning disorders, or certain medical syndromes.
(h) They recommend that diagnostic or genome-wide genetic testing should include counseling by a professional with expertise in both mental health and the interpretation of genetic tests.
(i) Consultation with a medical geneticist is recommended, if available, when a recognized genetic disorder is identified or when findings have reproductive or other broad health implications.
(j) Whenever genome-wide testing is performed, the possibility of incidental (secondary) findings must be communicated in a clear and open manner.
(k) Genetic test results, like all medical records, are private data and must be safeguarded against unauthorized disclosure with advanced encryption and computer security systems.
For more details ==> https://ispg.net/genetic-testing-statement/
Dr. Harvinder Singh, M.D.
(Admin & Course Instructor)
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