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Phenoconversion of Cytochrome P450 2D6: The Need for Identifying the Intermediate Metabolizer Genotype

J Clin Psychiatry 2013;74(10):1025 [letter]
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To the Editor: Preskorn and colleagues reported on an impressively large population-based study among 900 patients who recently started venlafaxine treatment and who were both genotyped and phenotyped for cytochrome P450 (CYP) 2D6 metabolism. Among these patients, 3.9% and 27.0%, respectively, were genotyped and phenotyped as a poor metabolizer. The investigators inferred that “personalized medicine solely based on genetics can be misleading.”(p614) Although we agree with this statement, some issues could have been addressed more extensively to underscore the need for pharmacogenetics.