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Figure 2 | BMC Medicine

Figure 2

From: Towards the clinical implementation of pharmacogenetics in bipolar disorder

Figure 2

Integrating pharmacogenetic test results. An algorithm for translating genotypes into specific recommendations for drugs commonly used in BD is illustrated. In making an overall treatment recommendation, all possible drug-genotype combinations are classified into four outcome categories. The overall recommendation is optimized to avoid the worst outcome predicted by PGT. Drug-genotype combinations associated with serious and/or potentially life threatening outcomes are given lowest priority (Use with caution). Drug-genotype combinations with an elevated risk of long term side effects or that are predicted to require higher dosing requirements are given the next lowest priority (Potential limitations to use). Drug-genotype combinations that are not associated with an increase in adverse events are recommended for use in accordance with standard practices (Use as directed), and those without an elevated risk for adverse events, and an association with good psychiatric outcomes are given highest priority (Preferential use). EM, extensive metabolizer; IM, intermediate metabolizer; NA, not available; PM, poor metabolizer; TD, tardive dyskinesia; UM, ultra-rapid metabolizer; UNKN: unknown.

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