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Chunk #30 — How and Where Pharmacogenomic Testing Should Be Performed

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Pharmacogenomic testing for neuropsychiatric drugs: current status of drug labeling, guidelines for using genetic information, and test options.
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The information included in Table 2 illustrates that currently available platforms relevant to pharmacogenomic testing for neuropsychiatric medications encompass a range of gene variants or alleles that are genotyped. This introduces some limitations when assigning genotype-inferred phenotypes. Since the list of genotyped alleles and possible copy number variation is not comprehensive for all platforms, the assigned phenotype is predicted to the best of available knowledge and may be a source of discrepancies between platforms. For example, if a given platform is unable to assess CYP2D6 gene duplication, important information predicting UMs can be easily missed. Additionally, the star (*) nomenclature commonly used for assigning allele status for drug-metabolizing enzyme genes defaults to the wild-type or *1 allele in the absence of a variant. Thus when a specific variant is not tested, there is the risk of misclassification of the *1 allele.