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Meta-analysis of pharmacogenetic clinical decision support systems for the treatment of major depressive disorder


The study aimed to conduct a meta-analysis of studies comparing pharmacogenetically guided dosing of antidepressants with empiric standard of care. Publications referring to genotype-guided antidepressant therapy were identified via PubMed, Google Scholar, Scopus, Web of Science, Embase, and Cochrane databases from the inception of the databases to 2021. In addition, bibliographies of all articles were manually searched for additional references not identified in primary searches. Studies comparing clinical outcomes between two groups of patients who received antidepressant treatment were included in meta-analysis. Analysis of the data revealed statistically significant differences between the experimental group receiving pharmacogenetically guided dosing and the empirically treated controls. Specifically, genotype-guided treatment significantly improved response and remission of patients after both eight and twelve weeks of therapy, whereas no effect on the development of adverse drug reactions was observed. This meta-analysis indicates that the use of preemptive genotyping to guide dosing of antidepressants might increase treatment efficacy.

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Fig. 1: Forest plot of meta-analyses of studies on therapy response data at week 8 of treatment.
Fig. 2: Forest plot of meta-analyses of studies on remission onset at week 8 of treatment.
Fig. 3: Forest plot of meta-analyses of studies on therapy response at week 12 of treatment.
Fig. 4: Forest plot of meta-analyses of studies on remission onset at week 12 of treatment.
Fig. 5: Forest plot of meta-analyses of studies on adverse drug reactions development at week 12 of treatment.

Data availability

The datasets generated during and/or analyzed during the preparation of the current meta-analysis, are available from the corresponding author on reasonable request.


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Authors and Affiliations



VS: Conceptualization, Investigation, Data Curation, Writing—Original Draft, Writing-Review & Editing. IR: Conceptualization, Methodology, Validation, Investigation, Data Curation, Writing—Original Draft. MZ: Conceptualization, Formal Analysis, Writing—Original Draft, Visualization. VL: Conceptualization, Validation, Writing—Original Draft, Writing—Review & Editing. JF: Methodology, Writing—Original Draft, Supervision. EB: Writing—Review & Editing, Supervision. DS: Writing—Review & Editing, Supervision.

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Correspondence to Valentin Skryabin.

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Competing interests

VML is co is CEO and shareholder of HepaPredict AB, co-founder and shareholder of PersoMedix AB and discloses consultancy work for Enginzyme AB.

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Skryabin, V., Rozochkin, I., Zastrozhin, M. et al. Meta-analysis of pharmacogenetic clinical decision support systems for the treatment of major depressive disorder. Pharmacogenomics J (2022).

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