Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life Depression?

Ryan Abbott, Donald D. Chang, Harris A. Eyre, Chad A. Bousman, David A. Merrill, Helen Lavretsky

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


Clinicians still employ a “trial-and-error” approach to optimizing treatment regimens for late-life depression (LLD). With LLD affecting a significant and growing segment of the population, and with only about half of older adults responsive to antidepressant therapy, there is an urgent need for a better treatment paradigm. Pharmacogenetic decision support tools (DSTs), which are emerging technologies that aim to provide clinically actionable information based on a patient's genetic profile, offer a promising solution. Dozens of DSTs have entered the market in the past 15 years, but with varying level of empirical evidence to support their value. In this clinical review, we provide a critical analysis of the peer-reviewed literature on DSTs for major depression management. We then discuss clinical considerations for the use of these tools in treating LLD, including issues related to test interpretation, timing, and patient perspectives. In adult populations, newer generation DSTs show promise for the treatment of major depression. However, there are no primary clinical trials in LLD cohorts. Independent and comparative clinical trials are needed.

Original languageEnglish (US)
Pages (from-to)125-133
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Issue number2
StatePublished - Feb 2018


  • decision support tool
  • Depression
  • genetic testing
  • geriatric
  • late-life depression
  • pharmacogenomic
  • precision medicine

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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