Neurological and Psychiatric PGx Panel
Test Description
The Neurological and Psychiatric PGx Panel is intended for individuals receiving neurologic or psychiatric therapies who may benefit from personalized pharmacogenetic-guided medication management. This panel evaluates clinically relevant genetic variants associated with drug metabolism, efficacy, tolerability, and adverse reaction risk for a broad range of medications commonly used in the treatment of epilepsy, mood disorders, anxiety, ADHD, psychotic disorders, sleep disorders, and other neurologic or psychiatric conditions. Pharmacogenetic testing may help guide medication selection and dosing, reduce the risk of serious adverse drug reactions, improve therapeutic response, and support safer, more effective individualized treatment strategies. Upon completion of testing, patients receive an interpretive pharmacogenetic report and certificate summarizing clinically relevant results and medication-related findings to support ongoing care and future treatment decisions.
Ordering Information
Turnaround Time: 3-7 business days
Preferred specimens: Saliva
Alternate specimens: Buccal Swab
Clinical description
Many of patients with depression do not respond to their first anti depression medications. Response to these medications may be under genetic influence. In addition, the genetic profile of individuals may explain the differences in response to some of anti-seizure, anti- anxiety medications as well as other medications commonly used to treat neurological and psychiatric conditions.
Neurological and Psychiatric Medications
| Medication | Gene |
| Carbamazepine, Oxcarbazepine, Phenytoin, Fosphenytoin | HLA-B*1502 |
| Phenytoin, Siponimod, Fosphenytoin | CYP2C9 |
| Brivaracetam, Moclobemide, Clobazam, Sertraline, Citalopram, Escitalopram, Diazepam, Amitriptyline, Clomipramine, Doxepin, Trimipramine, Imipramine | CYP2C19 |
| Trazodone, Guanfacine, Eszopiclone, Alprazolam, Buspirone, Clonazepam, Cyclosporine, Quetiapine | CYP3A4, CYP3A5 |
| Sertraline | CYP2B6 |
| Bupropion | ANKK1 |
| Methylphenidate, Clonidine | ADRA2A |
| Dextroamphetamine, Methylphenidate, Lisdexamfetamine, Dexmethylphenidate, Amphetamine | COMT |
| Oxazepam, Lorazepam | UGT2B15 |
| Succinylcholine | BCHE |
| Haloperidol, Olanzapine, Iloperidone, Aripiprazole, Aripiprazole Lauroxil, Pimozide, Risperidone, Thioridazine, Perphenazine, Clozapine, Brexpiprazole, Zuclopenthixol, Mirtazapine, Amitriptyline, Vortioxetine, Venlafaxine, Clomipramine, Desipramine, Doxepin, Duloxetine, Protriptyline, Flupenthixol, Nortriptyline, Fluvoxamine, Paroxetine, Fluoxetine, Donepezil, Fesoterodine, Tolterodine, Atomoxetine, Tetrabenazine, Galantamine, Dextromethorphan-Quinidine, Sertindole, Cevimeline, Amphetamine, Dapoxetine, Amoxapine, Trimipramine, Imipramine, Pitolisant, Tolperisone, Deutetrabenazine, Valbenazine | CY2D6 |
Frequency of Cytochrome P450 (CYP2D6, CYP2C9, CYP2C19) Metabolizer Types in the Population
| Cytochrome | Poor metabolizer | Intermediate metabolizer | Normal metabolizer | Rapid or ultra-rapid metabolizer |
| CYP2D6 | 4-7% | 9-35% | 50-90% | 2-3% |
| CYP2C9 | 3% | 30% | 68% | N/A |
| CYP2C19 | 2-20% | 24-36% | 14-44% | 30% |
Tagged Genes
- Evans WE, McLeod HL. Pharmacogenomics—drug disposition, drug targets, and side effects. N Engl J Med. 2003;348(6):538–549.
- Johnson JA, Cavallari LH. Pharmacogenetics and cardiovascular disease: implications for personalized medicine. Pharmacol Rev. 2013;65(3):987–1009.
- Cavallari LH, Lee CR, Beitelshees AL, et al. Multisite investigation of outcomes with implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention. JACC Cardiovasc Interv. 2018;11(2):181–191. doi:10.1016/j.jcin.2017.07.022
- Jneid H, Anderson JL, Wright RS, et al. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non–ST-elevation myocardial infarction. Circulation. 2012;126(7):875–910. doi:10.1161/CIR.0b013e318256f1e0
- Scott SA, Sangkuhl K, Stein CM, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther. 2013;94(3):317–323. doi:10.1038/clpt.2013.105
- Johnson JA, Caudle KE, Gong L, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. Clin Pharmacol Ther. 2017.
- Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial. Lancet. 2010;376(9753):1658–1669. doi:10.1016/S0140-6736(10)60310-8
- The SEARCH Collaborative Group. SLCO1B1 variants and statin-induced myopathy—a genomewide study. N Engl J Med. 2008;359(8):789–799. doi:10.1056/NEJMoa0801936
- Clinical Pharmacogenetics Implementation Consortium (CPIC). Genes–drug pairs.
- U.S. Food and Drug Administration. Table of pharmacogenomic biomarkers in drug labeling.