Pharmacogenomics to optimise psychotropic prescribing: a survey of mental health professionals’ perceptions, knowledge, and educational needs

The Pharmacogenomics Journal ARTICLE www.nature.com/tpj OPEN Pharmacogenomics to optimise psychotropic prescribing: a survey of mental health professionals’ perceptions, knowledge, and educational needs ✉ Daniele Panconesi 1,2,13 , Stephen Murtough 1,13, Marius Cotic1, Noushin Saadullah Khani1, Lauren Varney1, 1 Maria Richards-Brown , Rosemary Abidoph1, Daisy Mills 1, Alvin Richards-Belle1, Jazmin Molai2, James Fenwick2, Joanna Curwen2, Matthew Allin2, Alex Berry 2, Magdalana Barczyk2, Stefania Bonaccorso2, Rebecca Griffiths2, Massimo Bernini3, Ajai Kumar3, Suruthy Senthilkumar 3, Yogita Dawda 3, Rajvinder Shokkar4, Rosie Murdoch4, Jamie Crane4, Yousuf Rahimi4, Myles Howard5, Alison Welfare-Wilson5, Agostina Secchi5, Carmel Thomas6, Bethany Pastor6, Parveen Sharma6, Georgy Pius6, Rashad Nazir6, Asif Mir6, Jack Cheshire7, Rhianne Bostock7, Simon Gibbon7, Pratima Singh 8, Chetan Shah8, Sabrina Richards8, Sai-Bo Cheung9, ✉ Louise Rowe-Leete9, Anita Jibero 10, Rebecca Cox10, Philip Van Driel11 and Elvira Bramon 1,2,12 1234567890();,: © The Author(s) 2026 A survey was conducted to determine attitudes, knowledge, and educational needs of mental health professionals regarding pharmacogenomics. We recruited 128 clinicians working in mental health in England, and we assessed their experiences using an adapted version of the “U‐PGx Clinician’s Questionnaire”. Responding clinicians had positive attitudes towards pharmacogenomics testing, although they lacked confidence in ordering and interpreting tests, for which most had never received any formal training. Only 6% of clinicians answered all 4 knowledge testing questions correctly, and barriers to clinical implementation included lack of familiarity and knowledge for several pharmacogenomics concepts, such as drug metabolism and genetics, as well as needing support from their working institution. Looking ahead, we found that accredited workshops and patient cases were preferred learning formats, and we suggest tailored education programmes to enable mental health professionals to apply pharmacogenomics in clinical practice. The Pharmacogenomics Journal (2026)26:2 ; https://doi.org/10.1038/s41397-025-00394-x INTRODUCTION Genetic factors play an important role in drug response, including both the development of adverse drug reactions – at times serious and potentially life-threatening – as well as therapeutic effectiveness [1]. By integrating pharmacogenomics at the point of care, it may be possible to minimise adverse drug reactions [2], maximise drug efficacy, reduce drug-drug interactions, and select medications based on patients’ genetic profiles. The discovery of genetic variants with clinical utility for prescribing has been documented over the past decade. As a result, the FDA has incorporated pharmacogenomics information into drug labels for 388 different medications, accounting for a total of 593 drug-gene interactions [3]. 36 of those medications (totalling 9.3%) are used in mental health treatments and are linked to 40 drug-gene interactions (Appendix 1); highlighting clear potential for pharmacogenomics interventions in mental health and psychiatry. A growing body of evidence supports the use of genetic testing to inform drug prescribing, which is reflected in clinical guidelines developed by groups such as the Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG). In the UK’s National Health Service (NHS), there are a few examples of this personalised approach to drug prescribing to prevent adverse drug reactions [4]. Testing for DPYD genetic variants is available prior to treatment with fluoropyrimidines in oncology [5], and neonatal mitochondrial genetic testing is available before treatment with aminoglycosides to prevent deafness [6]. However, the implementation of pharmacogenomics into clinical mental health practice faces major challenges in the UK and many countries worldwide [1–9]. Previous research around clinicians’ attitudes, acceptance, and knowledge of pharmacogenomics have suggested that accessibility to and lack of confidence in applying and interpreting 1 Mental Health Neuroscience Department, Division of Psychiatry, University College London, London, UK. 2North London NHS Foundation Trust, London, UK. 3Central and North West London NHS Foundation Trust, London, UK. 4Berkshire Healthcare NHS Foundation Trust, Bracknell, UK. 5Kent and Medway NHS and Social Care Partnership, Maidstone, UK. 6 Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK. 7Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK. 8Hertfordshire Partnership NHS Trust, Hatfield, UK. 9Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK. 10South West London and St George’s Mental Health NHS Trust, London, UK. 11 Somerset NHS Foundation Trust, Taunton, UK. 12Institute of Cognitive Neuroscience, University College London, London, UK. 13These authors contributed equally: Daniele Panconesi, Stephen Murtough. ✉email: ; Received: 26 September 2024 Revised: 16 July 2025 Accepted: 5 December 2025 D. Panconesi et al. 2 genetic tests continues to limit their clinical use [10]. This highlights a need for standardised training programmes for medical and other clinical staff [7, 8]. Genetic testing is currently used to guide the treatment of several illnesses, especially in oncology and cardiology – areas of medical specialisation with the most extensive implementation of genetic testing to date. Meanwhile, translation of pharmacogenomics findings in mental health remains challenging [11], even though this is a medical specialty that could greatly benefit from pharmacogenomics implementation, for several reasons. Firstly, mental illness has major impact both on a personal and societal level. It is estimated that mental health conditions cost the UK economy over £117.9 billion every year, which is 5% of the UK’s Gross Domestic Product. These costs are mainly associated with healthcare costs, loss of work productivity, and informal caregiver support [12]. Similarly, in 2010, mental health conditions cost the USA, 2.5 billion USD, and this is expected to increase significantly by 2024. And the cost of managing nonresponders to antidepressant treatment is around 10,000 USD/ year/patient greater than it is for managing responsive patients [13]. Secondly, the Sequence Treatment Alternatives to Relieve Depression trial [14] found that the response rate to initial antidepressant treatment was only 47%, and a systematic review concluded that non-responders to antidepressants were 15% more likely to attempt suicide, compared to 6% of patients with treatment-responsive depression and 1% of the general population [15]. In addition to this, as little as 28–33% of patients who take selective serotonin reuptake inhibitors (SSRI) achieve remission after initial antidepressant treatment [14]. Importantly, a recent meta-analysis found that individuals on pharmacogenomi (...truncated)