PGx and TDM in Psychopharmacology


The optimization of pharmacy decisions is often based on trial-and-error, which may require several weeks to months for many drugs used in psychiatry due to less than desirable response, side effects, and potentially life-threatening toxicity. There are many medications available to treat depression, anxiety, schizophrenia, attention deficit and other behavioral health conditions. Research has shown that pharmacogenomics (PGx) and therapeutic drug monitoring (TDM) can help to inform drug and dose selections. This presentation will provide a background on PGx and TDM laboratory tests, along with some examples of how these tools are relevant to behavioral health.

Originally published on June 9, 2020

Lecture Presenter

Gwendolyn A. McMillin, PhD, DABCC(CC,TC)

Gwendolyn A. McMillin, PhD, DABCC(CC,TC)

Medical Director, Toxicology; Medical Director, Pharmacogenetics; Scientific Director, Mass Spectrometry Platform
ARUP Laboratories
Professor of Pathology
University of Utah School of Medicine

Dr. Gwendolyn A. McMillin is the scientific director of the mass spectrometry platform at ARUP Laboratories as well as the medical director of clinical toxicology and pharmacogenomics. She is also a professor at the University of Utah School of Medicine. Dr. McMillin received her doctorate degree in pharmacology from the University of Utah, where she also completed a clinical chemistry fellowship. Dr. McMillin is board certified in clinical chemistry and toxicological chemistry. Her research interests include pharmacogenomics, newborn drug exposures, and analytical methods. She is the recipient of the Past Chair award, the Ellis Benson Young Investigator award, and the Outstanding Speaker award.


After this presentation, participants will be able to:

  • Explain the relationships between pharmacogenomics, therapeutic drug monitoring, and clinical monitoring.
  • Describe the concept of activity scores for CYP2D6.
  • Discuss possible indications for PGx and TDM.
  • List examples of gene-drug pairs classified by the FDA to support therapeutic management recommendations.

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories