Psychopharmacology and Psychiatry Updates Pharmacogenetics-Guided Dosing: Poor vs. Rapid Metabolizers
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Jan 16, 2026 Dr. Chris Aiken, a psychiatrist and educator, dives deep into pharmacogenetics-guided dosing. He reveals how understanding whether patients are poor or rapid metabolizers can change treatment outcomes dramatically. Aiken emphasizes tailored dosing strategies: for poor metabolizers, he suggests starting low and going slow, while for rapid metabolizers, targeting higher doses works best. He also discusses the importance of monitoring clinical response and serum levels, highlighting a personalized approach to psychiatric care. A must-listen for mental health professionals!
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Fiona: A Case That Frames The Problem
- Richard Seeber presents Fiona, a 32-year-old on standard antidepressant with severe side effects.
- This case frames how pharmacogenetics can explain side effects from standard dosing.
Start Low And Go Slow For Poor Metabolizers
- Start poor metabolizers at half the usual dose and titrate twice as slowly as normal.
- Lower the target dose by about 30–70% to reduce risk of side effects.
Aim Higher For Rapid Metabolizers
- For rapid metabolizers, aim for a higher target dose and titrate faster.
- Increase the dose toward 135–180% of standard dosing while monitoring for side effects.