Discover some eye-opening exploration of genetics, medication choices, and evidence-based practices in pediatric psychiatry!  Join host Dr. Lia Gaggino and guest Dr. Lisa Namerow  as they navigate the intricate world of pharmacogenomic testing, the impact on prescribing behavior, and the crucial relevance of genetic panels for pediatric patients. From the evolving landscape of pharmacogenomics to the challenges of interpreting genetic findings, this discussion sheds light on the pivotal role of nonpharmacologic options and the need for validated guidelines in treating pediatric anxiety and depression. The conversation between Dr. Gaggino and Dr. Namerow has shed light on the challenges and opportunities associated with pharmacogenomic testing in pediatric psychiatry. With the complexity of interpreting results and the risk of inappropriate medication choices, the field faces a critical juncture in the responsible adoption and implementation of genetic information. However, the lack of clear guidelines and the risk of misinterpretation highlight the need for caution in prescribing decisions. As we navigate this landscape, it is essential for providers to prioritize the validation of guidelines and the responsible use of genetic information to ensure the safe and effective treatment of pediatric anxiety and depression. Together, we can work towards a future where genetic testing enhances the care of pediatric patients facing mental health challenges.

[00:33 -12:41] The Conundrum of Genetics in Psychiatry

• Genetics play a complex role in determining the right treatment for psychiatric conditions.
• Non-specialists may struggle to fully comprehend the intricacies of genetic information.
• The science of genetics in mental health treatment is fast evolving.
• Genetic information can significantly alter clinical decisions in unexpected ways.

[12:42 - 28:33]  Understanding Clinical Pharmacogenetics  

• Learn what pharmacogenetics is and how it impacts drug efficacy and patient safety.
• Identify common drugs with known pharmacogenetic interactions.
• Understand the importance of integrating pharmacogenetic information into clinical practice.
• Stay updated on emerging research and its implications for personalized medicine.

[28:34 - 33:05] Moving Beyond the Binning Concept in Data Analysis

• Embrace new frameworks for interpreting genetic testing results.
• Develop a nuanced understanding free from oversimplified categories.
• Foster continuous learning and adaptation in data evaluation methods.
• Integrate complex data sets for a more personalized approach to healthcare.

[33:06 - 44:13]  Utilizing Sequence to Script in Clinical Practice 

• Streamline patient information intake by inputting data into Sequence to Script.
• Enhance patient interactions by leveraging generated scripts for more effective communication.
• Document clinical reasoning meticulously when selecting treatment options based on script suggestions.
• Improve the accuracy of allergy identification and management with advanced Sequence to Script outputs. 

[44:14 - 51:44]  Closing segment Takeaway

Links to resources mentioned on the show

Sequence 2 Script:  www.sequence2script.org

Pharmacogenomics:  An Update for Child and Adolescent Psychiatry  https://experts.umn.edu/en/publications/pharmacogenomics-an-update-for-child-and-adolescent-psychiatry

Editorial:  Beyond Red Light Green Light:                                                                            https://europepmc.org/article/med/34767918

Child Psychiatry Access Programs by state:                                                                                                       https://www.nncpap.org/map

Other episodes you may like:

https://pediatricmeltdown.com/episodes

Ep 45  Pharmacogenomics: How Genetic Testing Can Help Us

Ep 44  Anxiety Disorders in Children: Treatment Pearls

Key quotes for Twitter:

"Given the current evidence base, consider pharmacogenetic testing. If the medication that you have determined through your evaluation and evidence-based review has relevant gene medication associations, then consider pharmacogenetics."... Dr. Lisa Namerow on The Future of Pharmacogenetics:

"We know that if we see a kid who's being treated with Des Venlafaxine or Pristiq for depression or anxiety, that patient has gotten pharmacogenetic testing."... Dr. Lisa Namerow on Pharmacogenetic Testing

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