CPIC® Guideline for Serotonin Reuptake Inhibitor Antidepressants and CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A

Most recent guideline publication:

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants (April 2023)

Updates since publication:

None

Tables provided in the main manuscript of the guideline:

Table 1. Assignment of predicted phenotypes based on diplotypes

Table 2. Dosing recommendations for antidepressants based on CYP2D6 phenotype

Table 3. Dosing recommendations for antidepressants based on CYP2C19 phenotype

Supplement to: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants (April 2023)

Tables and figures included in the supplement^a or referenced in the guideline:

Table S1. Evidence linking CYP2D6, CYP2C19 and CYP2B6 genotype to SSRI phenotype

Table S2. Evidence linking CYP2D6 genotype to SNRI and serotonin modulator phenotype

Table S3. Evidence linking SLC6A4 genotype to antidepressant phenotype

Table S4. Evidence linking HTR2A genotype to antidepressant phenotype

Table S5. Metabolism of antidepressants included in this guideline.

Table S6. Dosing Recommendation for fluoxetine based on CYP2D6 phenotype

Table S7. Dosing recommendations for citalopram and escitalopram based on HTR2A genotype

Table S8. Dosing recommendations for fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, desvenlafaxine, vilazodone, vortioxetine, levomilnacipran and milnacipran based on HTR2A genotype

Table S9. Dosing recommendations citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, desvenlafaxine, vilazodone, vortioxetine, levomilnacipran and milnacipran based on SLC6A4 genotype

Table S10. Meta-analyses of evidence linking genetic variation to antidepressant phenotypes

CYP2D6 allele definition table  CYP2C19 allele definition table  CYP2B6 allele definition table

CYP2D6 allele functionality table CYP2C19 allele functionality table  CYP2B6 allele functionality table

CYP2D6 frequency table  CYP2C19 frequency table  CYP2B6 frequency table

CYP2D6 diplotype-phenotype table  CYP2C19 diplotype-phenotype table  CYP2B6 diplotype-phenotype table

Gene resource mappings CYP2D6 CYP2C19 CYP2B6

Drug Resource mappings Citalopram Escitalopram Fluvoxamine Paroxetine Sertraline Venlafaxine Vortioxetine

Clinical decision support:b Implementation workflow CYP2D6 consult  CYP2C19 consult CYP2B6 consult Citalopram pre- and post-test alerts and workflow Escitalopram pre- and post-test alerts and workflow Fluvoxamine pre- and post-test alerts and workflow Paroxetine pre- and post-test alerts and workflow Sertraline pre- and post-test alerts and workflow Venlafaxine pre- and post-test alerts and workflow Vortioxetine pre- and post-test alerts and workflow