Background

Fluoxetine is the first-line medication for adolescent depression, with five other selective serotonin reuptake inhibitors (SSRIs) recommended for consideration if fluoxetine is ineffective or not tolerable. The Guidelines for Adolescent Depression in Primary Care (GLAD-PC) outlines the management of these medications. However, GLAD-PC does not account for metabolism phenotype, which can lead to variability in efficacy and tolerability. Pharmacogenetic (PGx) testing identifies metabolism phenotype and may decrease trial-and-error time in prescribing.

Research Question 

Is PGx-guided prescribing superior to GLAD-PC prescribing for achieving remission after 12 weeks in depressed adolescents? 

Trial Overview 

This triple-blind randomized controlled trial will enrol 284 adolescents aged 12–17 years over 45 months with moderate to severe depression who have not responded to fluoxetine treatment. Participants will be allocated on a 1:1 ratio for their physician to receive either PGx-guided or GLAD-PC prescribing recommendations for alternate SSRIs. Patient-reported outcome data including depressive symptoms, role functioning, medication adherence, and adverse drug reactions and side effects will be collected at 4, 8, and 12 weeks.  

Team

Principal Investigators: 

Dr. Chad Bousman

Dr. Amanda Newton

Co-Investigators:

Dr. Paul Arnold

Dr. Katherine Rittenbach

Dr. Ross Tsuyuki

Dr. Jennifer Zwicker

Study Coordinators: 

Laina McAusland 

Meagan Hayashi 

Laboratory Team

Sarker M Shaheen

Ryden McCloud-Trenchard

Partners

University of Calgary

University of Alberta

Alberta Precision Laboratories

EPICORE Centre

Mathison Centre for Mental Health Research & Education

Alberta Provincial Addiction and Mental Health Portfolio 

Primary Health Care Integration Network

Funding Support