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.
Is PGx-guided prescribing superior to GLAD-PC prescribing for achieving remission after 12 weeks in depressed adolescents?
This triple-blind randomized controlled trial will enrol 452 adolescents aged 12–17 years 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.
Dr. Chad Bousman
Dr. Amanda Newton
Dr. Paul Arnold
Dr. Katherine Rittenbach
Dr. Ross Tsuyuki
Dr. Jennifer Zwicker
Sarker M Shaheen
University of Calgary
University of Alberta
Alberta Precision Laboratories
Mathison Centre for Mental Health Research & Education
Alberta Provincial Addiction and Mental Health Portfolio
Primary Health Care Integration Network