Individualizing selection and dosage of medications prescribed for treatment of depression and other psychiatric disorders based on genetic variation
Identifying genetic variation in genes known to be associated with response and/or risk of toxicity with psychotropic medications
Evaluating patients who have failed therapy with selective serotonin reuptake inhibitors (SSRIs)
Evaluating patients with treatment-resistant depression
Predicting response time to improvement with SSRIs
This test includes targeted testing to evaluate the following genes: ANKK1, ADRA2, CHRNA3, COMT, CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, DRD2, EPHX1, GRIK4, HLA-A*31:01, HLA-B*15:02, HTR2A, HTR2C, MTHFR, OPRM1, SCN1A, SLC6A4 (5-HTT), UGT2B15.
CYP2D6 testing is done in 2 tiers when needed. Tier 1 uses a PCR-based 5'-nuclease assay to determine the variants present. All samples also have copy number determined by PCR-based 5'-nuclease assay. Testing in tier 1 allows for the detection of all common CYP2D6 variants (eg, *2, *3, *4, *5, *6, *7, *8, *9, *10, *17, *29, *35, *41) and rarer alleles such as *11, *12, *14A, *14B, and *15. Duplications and multiplications of alleles are also identified. Unitary and tandem CYP2D7-2D6 (*13) alleles and CYP2D6-2D7 (eg, *4N, *36, and *68) alleles can also be detected. Tier 2 testing involves sequencing using fluorescent dye-terminator chemistry and is only done if an ambiguous phenotype results from tier 1 testing. Approximately 3% of samples require tier 2 testing.
If a specimen requires follow-up for CYP2D6, then reflex testing will be performed as appropriate at an additional charge.
See CYP2D6 Comprehensive Cascade Testing Algorithm in Special Instructions.
Real-Time Polymerase Chain Reaction (RT-PCR) with Allelic Discrimination Analysis
Qualitative Allele-Specific Real-Time Polymerase Chain Reaction (PCR)
PCR Followed by Sizing Analysis
