CPIC Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4 and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants

The CPIC guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4 and HTR2A genotypes and Serotonin Reuptake Inhibitor Antidepressants has been published in the journal Clinical Pharmacology and Therapeutics. This new guideline updates the CPIC guideline for Selective Serotonin Reuptake Inhibitors and CYP2D6 and CYP2C19, and includes additional Serotonin Reuptake Inhibitor Antidepressants and three additional genes, CYP2B6, HTR2A, and SLC6A4.

The guideline gives specific prescribing recommendations for:

• paroxetine, fluvoxamine, venlafaxine, and vortioxetine based on CYP2D6 phenotypes
• escitalopram and citalopram based on CYP2C19 phenotypes
• sertraline based on CYP2C19 and CYP2B6 phenotypes

Clinical recommendations are not provided for serotonin reuptake inhibitor antidepressants based on HTR2A and SLC6A4 genotypes because the current evidence is mixed and/or insufficient to support clinical validity and utility.

For specific recommendations and further details, please refer to the guideline and supplemental materials on the CPIC website. Annotations of the guideline, including an interactive genotype picker tool for the drugs mentioned above, are available on the PharmGKB website.