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Example report. Made from Leslie Knope's DNA data so you can see what yours will look like. Get your own report

Psychiatric Report

Prepared for Leslie Knope

Version 4.6

Example made Nov 8, 2026

How these genes may affect your response to medications.

Data source
23andMe
Genome build
GRCh37
Genes analyzed
4
Medications
28
How to read this report
  1. Step 1

    Two copies of each gene

    You inherit one copy from each parent. The report names the pair, such as *1/*2.

  2. Step 2

    The pair gives a gene result

    Such as Poor metabolizer. The color shows it: typical, reduced, poor.

  3. Step 3

    The result sets each medication's label

    Consider alternative Use with caution Use as directed Unable to determine

  4. Step 4

    Then talk to your prescriber

    Don't change or stop a medication on your own. Unable to determine doesn't mean normal.

Read the full guide: How to read your Gene2Rx report

What are you looking for?

Find a medication by generic or brand name, or look up a drug class or a gene, among the 28 medications in this report.

Or browse:AntidepressantsAntipsychoticsADHD medications

What stands out in your genes

See all 4 genes

Your genes at a glance

All 4 results. Find more details in the Genes section, or select a gene below for its full explanation.

Each dot is a copy
  • works normally
  • doesn't work
  • Letters: your DNA letters, where copy function isn’t defined
Color is the result
  • Normal / typical / favorable
  • Intermediate / decreased
  • Poor / increased risk
  • Rapid / increased
  • Not determined
Gene results, part 1
GeneResult
CYP2D6
Poor metabolizer*4/*4
CYP2C19
Intermediate metabolizer*1/*2
Gene results, part 2
GeneResult
CYP2B6
Normal metabolizer*1/*1
CYP3A4
Normal metabolizer*1/*1

Worth discussing with your prescriber

For these 9 medications, guidelines suggest considering another option. Share this list before you start something new.

Antidepressants
AmitriptylineClomipramineDesipramineDoxepinImipramineNortriptylineTrimipramineVenlafaxine
Antipsychotics
Thioridazine

Don't change a dose on your own. Bring this report to your prescriber or pharmacist. They can weigh it with everything else they know about you.

All medications

28 medications in 3 groups. Open any medication to see the guideline behind its label.

Browse drug classes
  • Consider alternative
  • Use with caution
  • Use as directed

Showing 28 of 28

Antidepressants14 medications

Compare antidepressants All drug classes

SNRIs

VenlafaxineEffexor XR Consider alternative Your body breaks down this drug much more slowly, which has been linked to more side effects. A different antidepressant may be a better choice.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Consider alternative Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body breaks down this drug much more slowly, which has been linked to more side effects. A different antidepressant may be a better choice.
What it means
Decreased metabolism of venlafaxine to the active metabolite O-desmethylvenlafaxine and greatly decreased O-desmethylvenlafaxine:venlafaxine ratio compared with normal and intermediate metabolizers. Although the clinical impact is unclear, poor metabolizer status has been associated with adverse effects.
What the guideline suggests
Consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down venlafaxine much more slowly than normal, causing the drug to build up in your system. A lower dose may be needed to avoid side effects.
What it means
Alters systemic parent drug and metabolite concentrations. Consider dosage reductions.
What the label suggests
Consider dosage reductions.

See full details for venlafaxine

SSRIs

CitalopramCelexa Use with caution Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly.CYP2C19Intermediate metabolizer

CYP2C19Intermediate metabolizer

CPIC guideline

Use with caution Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly.
What it means
Reduced metabolism when compared with CYP2C19 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.
What the guideline suggests
Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers.

FDA drug label

Use as directed See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down citalopram slightly slower than normal. The standard dose should work as expected.
What it means
No FDA guidance for your genotype
What the label suggests
Initiate therapy with recommended starting dose.

See full details for citalopram

EscitalopramLexapro Use with caution Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly.CYP2C19Intermediate metabolizer

CYP2C19Intermediate metabolizer

CPIC guideline

Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly.
What it means
Reduced metabolism when compared with CYP2C19 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.
What the guideline suggests
Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose than normal metabolizers.

See full details for escitalopram

FluvoxamineLuvox Use with caution Your body breaks down this drug much more slowly. A lower starting dose, a slower increase, or a different drug may be safer.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body breaks down this drug much more slowly. A lower starting dose, a slower increase, or a different drug may be safer.
What it means
Greatly reduced metabolism of fluvoxamine to less active compounds compared with normal metabolizers. Higher plasma concentrations may increase the probability of side effects.
What the guideline suggests
Consider a 25 to 50% lower starting dose and slower titration schedule as compared with normal metabolizers or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6.

See full details for fluvoxamine

ParoxetinePaxil, Seroxat Use with caution Your body processes this drug very slowly, so you may need half the usual dose to avoid side effects.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body processes this drug very slowly, so you may need half the usual dose to avoid side effects.
What it means
Greatly reduced metabolism compared with CYP2D6 normal metabolizers. Higher plasma concentrations may increase the probability of side effects.
What the guideline suggests
Consider a 50% reduction in recommended starting dose, slower titration schedule, and a 50% lower maintenance dose as compared with normal metabolizers.

See full details for paroxetine

SertralineZoloft Use with caution Your body processes this drug a bit more slowly. You can start at the usual dose, but your doctor may raise it slowly, and a lower ongoing dose may be enough.CYP2C19Intermediate metabolizerCYP2B6Normal metabolizer

CYP2C19Intermediate metabolizerCYP2B6Normal metabolizer

CPIC guideline, both genes together

Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body processes this drug a bit more slowly. You can start at the usual dose, but your doctor may raise it slowly, and a lower ongoing dose may be enough.
What it means
CYP2C19: Reduced metabolism of sertraline to less active compounds when compared to CYP2C19 normal metabolizers. CYP2B6: Normal metabolism of sertraline to less active compounds.
What the guideline suggests
Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose.

From the combined CYP2C19 and CYP2B6 table in CPIC's guideline for serotonin reuptake inhibitor antidepressants.

CPIC reads your CYP2C19 and CYP2B6 results together for sertraline, so this label reflects both genes.

See full details for sertraline

VortioxetineTrintellix, Brintellix Use with caution Your body clears this drug much more slowly. Half the usual starting dose is advised, or a different antidepressant.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Use with caution Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body clears this drug much more slowly. Half the usual starting dose is advised, or a different antidepressant.
What it means
Greatly reduced metabolism of vortioxetine to inactive compounds compared with normal metabolizers. Higher plasma concentrations may increase the probability of side effects.
What the guideline suggests
Initiate 50% of starting dose (e.g., 5 mg) and titrate to the maximum recommended dose of 10 mg or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down vortioxetine much more slowly than normal, causing the drug to build up to higher levels. A lower maximum dose is recommended to reduce the risk of side effects.
What it means
Results in higher systemic concentrations. The maximum recommended dose is 10 mg.
What the label suggests
The maximum recommended dose is 10 mg.

See full details for vortioxetine

Tricyclics

AmitriptylineElavil Consider alternative Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.CYP2D6Poor metabolizerCYP2C19Intermediate metabolizer

CYP2D6Poor metabolizer (activity score 0.0)CYP2C19Intermediate metabolizer

CPIC guideline, both genes together

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.
What it means
CYP2D6: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects CYP2C19: Reduced metabolism of tertiary amines compared to normal metabolizers
What the guideline suggests
Avoid amitriptyline use. If a amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.

From the combined CYP2D6 and CYP2C19 table in CPIC's guideline for tricyclic antidepressants. CYP2D6 is matched on its activity score.

CPIC reads your CYP2D6 and CYP2C19 results together for amitriptyline, so this label reflects both genes.

Also inamitriptyline / chlordiazepoxide and amitriptyline / perphenazine

See full details for amitriptyline

ClomipramineAnafranil Consider alternative Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.CYP2D6Poor metabolizerCYP2C19Intermediate metabolizer

CYP2D6Poor metabolizer (activity score 0.0)CYP2C19Intermediate metabolizer

CPIC guideline, both genes together

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.
What it means
CYP2D6: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects CYP2C19: Reduced metabolism of tertiary amines compared to normal metabolizers
What the guideline suggests
Avoid clomipramine use. If a clomipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.

From the combined CYP2D6 and CYP2C19 table in CPIC's guideline for tricyclic antidepressants. CYP2D6 is matched on its activity score.

CPIC reads your CYP2D6 and CYP2C19 results together for clomipramine, so this label reflects both genes.

See full details for clomipramine

DesipramineNorpramin Consider alternative Your body breaks down this drug much more slowly, so it can build up and cause side effects. A different medicine is usually suggested.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body breaks down this drug much more slowly, so it can build up and cause side effects. A different medicine is usually suggested.
What it means
Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.
What the guideline suggests
Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.

See full details for desipramine

DoxepinSinequan, Quitaxon, Aponal Consider alternative Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.CYP2D6Poor metabolizerCYP2C19Intermediate metabolizer

CYP2D6Poor metabolizer (activity score 0.0)CYP2C19Intermediate metabolizer

CPIC guideline, both genes together

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.
What it means
CYP2D6: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects CYP2C19: Reduced metabolism of tertiary amines compared to normal metabolizers
What the guideline suggests
Avoid doxepin use. If a doxepin is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.

From the combined CYP2D6 and CYP2C19 table in CPIC's guideline for tricyclic antidepressants. CYP2D6 is matched on its activity score.

CPIC reads your CYP2D6 and CYP2C19 results together for doxepin, so this label reflects both genes.

See full details for doxepin

ImipramineTofranil Consider alternative Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.CYP2D6Poor metabolizerCYP2C19Intermediate metabolizer

CYP2D6Poor metabolizer (activity score 0.0)CYP2C19Intermediate metabolizer

CPIC guideline, both genes together

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.
What it means
CYP2D6: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects CYP2C19: Reduced metabolism of tertiary amines compared to normal metabolizers
What the guideline suggests
Avoid imipramine use. If imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.

From the combined CYP2D6 and CYP2C19 table in CPIC's guideline for tricyclic antidepressants. CYP2D6 is matched on its activity score.

CPIC reads your CYP2D6 and CYP2C19 results together for imipramine, so this label reflects both genes.

See full details for imipramine

NortriptylinePamelor Consider alternative Your body breaks down this drug very slowly, so it builds up and side effects are more likely. A different drug is usually suggested.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

CPIC guideline

Evidence: strongRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body breaks down this drug very slowly, so it builds up and side effects are more likely. A different drug is usually suggested.
What it means
Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers. Higher plasma concentrations of active drug will increase the probability of side effects.
What the guideline suggests
Avoid tricyclic use due to potential for side effects. Consider alternative drug not metabolized by CYP2D6. If a TCA is warranted, consider 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments.

See full details for nortriptyline

TrimipramineSurmontil Consider alternative Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.CYP2D6Poor metabolizerCYP2C19Intermediate metabolizer

CYP2D6Poor metabolizer (activity score 0.0)CYP2C19Intermediate metabolizer

CPIC guideline, both genes together

Evidence: optionalRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested.
What it means
CYP2D6: Greatly reduced metabolism of TCAs to less active compounds compared to normal metabolizers; Higher plasma concentrations of active drug will increase the probability of side effects CYP2C19: Reduced metabolism of tertiary amines compared to normal metabolizers
What the guideline suggests
Avoid trimipramine use. If a trimipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended.

From the combined CYP2D6 and CYP2C19 table in CPIC's guideline for tricyclic antidepressants. CYP2D6 is matched on its activity score.

CPIC reads your CYP2D6 and CYP2C19 results together for trimipramine, so this label reflects both genes.

See full details for trimipramine

Antipsychotics12 medications

Compare antipsychotics All drug classes

AripiprazoleAbilify Use with caution Your body clears aripiprazole slowly, so more of it builds up and side effects are more likely. A lower maximum dose is advised.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Use with caution Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears aripiprazole slowly, so more of it builds up and side effects are more likely. A lower maximum dose is advised.
What it means
Decreased CYP2D6 activity raises the combined blood level of aripiprazole and its active metabolite, increasing the risk of side effects.
What the guideline suggests
Administer no more than 10 mg/day, 300 mg/month or 720 mg/2 month (68-75% of the standard maximum dose of aripiprazole).

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down aripiprazole much more slowly than normal, causing the drug to build up and increasing the risk of side effects. A lower dose is recommended.
What it means
Results in higher systemic concentrations and higher adverse reaction risk. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations.
What the label suggests
Adjust the dosage as the FDA label directs for CYP2D6 poor metabolizers.

See full details for aripiprazole

Aripiprazole LauroxilAristada Use with caution Your body breaks down aripiprazole lauroxil more slowly than normal, causing higher levels of the drug in your system. A lower dose is recommended to reduce the risk of side effects.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

FDA drug label

See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down aripiprazole lauroxil more slowly than normal, causing higher levels of the drug in your system. A lower dose is recommended to reduce the risk of side effects.
What it means
Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations.
What the label suggests
Adjust the dosage as the FDA label directs for CYP2D6 poor metabolizers.

See full details for aripiprazole lauroxil

BrexpiprazoleRexulti Use with caution Your body clears brexpiprazole slowly, so more of it builds up. Half the usual dose is advised.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Use with caution Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears brexpiprazole slowly, so more of it builds up. Half the usual dose is advised.
What it means
Decreased CYP2D6 activity reduces the metabolism of brexpiprazole, so the risk of side effects is theoretically increased.
What the guideline suggests
Use half of the normal dose.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down brexpiprazole much more slowly than normal, causing the drug to build up in your system. A lower dose is recommended to reduce the risk of side effects.
What it means
Results in higher systemic concentrations. Dosage adjustment is recommended. Refer to FDA labeling for specific dosing recommendations.
What the label suggests
Adjust the dosage as the FDA label directs for CYP2D6 poor metabolizers.

See full details for brexpiprazole

ClozapineClozaril Use with caution Your body breaks down clozapine much more slowly than normal, causing the drug to build up to higher levels in your system. A lower dose may be needed to reduce the risk of side effects.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Use as directed Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your CYP2D6 result does not change how clozapine should be dosed.
What it means
CYP2D6 variation can change clozapine blood levels, but this has no clinical consequences.
What the guideline suggests
No action is required. Use standard clozapine dosing.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down clozapine much more slowly than normal, causing the drug to build up to higher levels in your system. A lower dose may be needed to reduce the risk of side effects.
What it means
Results in higher systemic concentrations. Dosage reductions may be necessary.
What the label suggests
Dosage reductions may be necessary.

See full details for clozapine

HaloperidolHaldol Use with caution Your body clears haloperidol slowly, which raises the concentration in your blood and increases side effect risk. A lower dose is typically recommended.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears haloperidol slowly, which raises the concentration in your blood and increases side effect risk. A lower dose is typically recommended.
What it means
Decreased CYP2D6 activity reduces conversion of haloperidol, increasing plasma concentration approximately 1.7-fold. This is associated with an increased risk of side effects.
What the guideline suggests
Use 60% of the normal dose.

See full details for haloperidol

IloperidoneFanapt Use with caution Your body breaks down iloperidone much more slowly than normal, causing the drug to build up and increasing the risk of heart rhythm problems. The dose should be cut in half.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

FDA drug label

See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down iloperidone much more slowly than normal, causing the drug to build up and increasing the risk of heart rhythm problems. The dose should be cut in half.
What it means
Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation). Reduce dosage by 50%.
What the label suggests
Reduce the dosage by 50%.

See full details for iloperidone

PerphenazineTrilafon Use with caution Your body breaks down perphenazine much more slowly than normal, causing the drug to build up in your system. This increases your risk of side effects.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

FDA drug label

See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down perphenazine much more slowly than normal, causing the drug to build up in your system. This increases your risk of side effects.
What it means
Results in higher systemic concentrations and higher adverse reaction risk.
What the label suggests
No specific dosing change in the FDA table. Refer to FDA labeling.

Also inamitriptyline / perphenazine

See full details for perphenazine

PimozideOrap Use with caution Your body clears pimozide slowly, which could raise the risk of heart rhythm side effects. Half the usual maximum dose is advised.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Use with caution Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears pimozide slowly, which could raise the risk of heart rhythm side effects. Half the usual maximum dose is advised.
What it means
Decreased CYP2D6 activity raises the plasma concentration of pimozide, which theoretically increases the risk of QT prolongation and torsade de pointes. Following the dose limit offsets this.
What the guideline suggests
Use no more than the following doses (50% of the normal maximum dose): 12 years and older, 10 mg/day; younger than 12 years, 0.05 mg/kg per day to a maximum of 2 mg/day.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down pimozide more slowly than normal, causing higher levels of the drug in your system. A lower dose is recommended to reduce the risk of side effects.
What it means
Results in higher systemic concentrations. Dosages should not exceed 0.05 mg/kg in children or 4 mg/day in adults who are poor metabolizers and dosages should not be increased earlier than 14 days.
What the label suggests
Do not exceed 0.05 mg/kg a day in children or 4 mg a day in adults, and do not increase the dose earlier than 14 days.

See full details for pimozide

QuetiapineSeroquel Use as directed Your CYP3A4 gene works normally, so the standard dose of this drug is used.CYP3A4Normal metabolizer

CYP3A4Normal metabolizer

DPWG guideline

Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your CYP3A4 gene works normally, so the standard dose of this drug is used.
What it means
No clinically significant effect on quetiapine metabolism.
What the guideline suggests
Use standard quetiapine dosing.

See full details for quetiapine

RisperidoneRisperdal Use with caution Your body clears risperidone slowly, so more of it builds up and side effects are more likely. About two-thirds of the usual dose is advised, and less if side effects still occur.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears risperidone slowly, so more of it builds up and side effects are more likely. About two-thirds of the usual dose is advised, and less if side effects still occur.
What it means
Decreased CYP2D6 activity raises the combined blood level of risperidone and its active metabolite, and a larger share of it is risperidone, which enters the brain more easily. The share of patients with therapy failure rises from 16% to 26%.
What the guideline suggests
Use 67% of the normal dose. If problematic side effects originating in the central nervous system occur despite this reduced dose, then reduce the dose further to 50% of the normal dose.

See full details for risperidone

ThioridazineMellaril Consider alternative Your body breaks down thioridazine much too slowly, causing dangerous levels to build up. This significantly increases your risk of serious heart rhythm problems. This medication should not be used.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

FDA drug label

Evidence: strongSee the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down thioridazine much too slowly, causing dangerous levels to build up. This significantly increases your risk of serious heart rhythm problems. This medication should not be used.
What it means
Results in higher systemic concentrations and higher adverse reaction risk (QT prolongation). Predicted effect based on experience with CYP2D6 inhibitors. Contraindicated in poor metabolizers.
What the label suggests
Do not use thioridazine. It is contraindicated for poor metabolizers due to dangerous heart rhythm risks.

See full details for thioridazine

ZuclopenthixolClopixol Use with caution Your body clears this drug slowly, so it builds up in your blood. Half the usual dose is advised.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

DPWG guideline

Evidence: moderateRead the guideline (Dutch Pharmacogenetics Working Group, opens in a new tab)

In plain words
Your body clears this drug slowly, so it builds up in your blood. Half the usual dose is advised.
What it means
Markedly decreased CYP2D6 activity reduces conversion of zuclopenthixol, raising plasma concentration approximately 1.6-fold and elevating side effect risk.
What the guideline suggests
Use 50% of the normal dose.

See full details for zuclopenthixol

Psychostimulants2 medications

Compare psychostimulants All drug classes

AmphetamineAdzenys ER Use with caution Your body breaks down amphetamine much more slowly than normal, which may cause the drug to build up and increase your risk of side effects. A lower dose or a different medication may be needed.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer

FDA drug label

See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down amphetamine much more slowly than normal, which may cause the drug to build up and increase your risk of side effects. A lower dose or a different medication may be needed.
What it means
May affect systemic concentrations and adverse reaction risk. Consider lower starting dosage or use alternative agent.
What the label suggests
Consider a lower starting dosage or an alternative agent.

Also inAdderall

See full details for amphetamine

AtomoxetineStrattera Use with caution Your body processes this drug very slowly, so it builds up. It may work well but cause more side effects, so your doctor may start low and go slowly.CYP2D6Poor metabolizer

CYP2D6Poor metabolizer (activity score 0.0)

CPIC guideline

Use with caution Evidence: moderateRead the guideline (Clinical Pharmacogenetics Implementation Consortium, opens in a new tab)

In plain words
Your body processes this drug very slowly, so it builds up. It may work well but cause more side effects, so your doctor may start low and go slowly.
What it means
Significantly decreased metabolism of atomoxetine may result in higher concentrations as compared to non- poor metabolizers. This may increase the occurrence of treatment-emergent side effects, but also a greater improvement of ADHD symptoms as compared with non- poor metabolizers in those who tolerate treatment. Poor metabolizer status is associated with lower final dose requirements as compared to non- poor metabolizers.
What the guideline suggests
Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose.

FDA drug label

Use with caution See the FDA table (U.S. Food and Drug Administration, opens in a new tab)

In plain words
Your body breaks down atomoxetine more slowly than normal, causing it to build up in your system. A lower dose or slower dose increases may be needed to reduce the risk of side effects.
What it means
Results in higher systemic concentrations and higher adverse reaction risk. Adjust titration interval and increase dosage if tolerated. Refer to FDA labeling for specific dosing recommendations.
What the label suggests
Adjust the titration interval and increase the dosage only if tolerated, as the FDA label directs.

See full details for atomoxetine

Your genes

4 genes from the 23andMe file. Results that differ from the most common one come first, then typical results.

Two dots per gene, one for each copy you inherited:

  • works normally
  • doesn't work

Color shows the overall gene result. Dot fill shows each copy’s function; lettered dots show your DNA letters where copy function isn’t defined.

  • Normal / typical / favorable
  • Intermediate / decreased
  • Poor / increased risk
  • Rapid / increased
  • Not determined

Not typical

2 genesYour result differs from the most common one. Not every difference changes the guidance for your medications.
  • CYP2D6

    Turns on or clears about 1 in 4 prescription drugs. These include many drugs for depression, pain and ADHD.

    Poor metabolizer*4/*4 · Neither copy works.
    0.0 activity scoreTypical: 1.25 to 2.25
    24 medicationsChanges the guidance for 24
    CYP2D6 poor metabolizer: estimated in 0.3% to 6.5% of people across population groups

    These CPIC estimates describe this phenotype, not your exact DNA combination or your chance of side effects. Frequencies vary by population; no ancestry is assumed for you.

    African American/Afro-Caribbean
    2.3%
    American
    2.0%
    Central/South Asian
    2.4%
    East Asian
    0.8%
    European
    6.5%
    Latino
    3.1%
    Near Eastern
    2.2%
    Oceanian
    0.3%
    Sub-Saharan African
    2.0%

    Estimated from published allele frequencies, rather than a direct count of people with this result. Study coverage and methods vary. Reference: CPIC CYP2D6 frequency table and methods. Data retrieved 2026-10-17.

  • CYP2C19

    Handles several SSRIs, acid reducers such as omeprazole, and the blood thinner clopidogrel.

    Intermediate metabolizer*1/*2 · One copy works and one doesn't.
    8 medicationsChanges the guidance for 8
    CYP2C19 intermediate metabolizer: estimated in 19.0% to 45.9% of people across population groups

    These CPIC estimates describe this phenotype, not your exact DNA combination or your chance of side effects. Frequencies vary by population; no ancestry is assumed for you.

    African American/Afro-Caribbean
    31.4%
    American
    21.4%
    Central/South Asian
    40.8%
    East Asian
    45.9%
    European
    26.1%
    Latino
    19.0%
    Near Eastern
    23.5%
    Oceanian
    36.9%
    Sub-Saharan African
    29.9%

    Estimated from published allele frequencies, rather than a direct count of people with this result. Study coverage and methods vary. Reference: CPIC CYP2C19 frequency table and methods. Data retrieved 2026-10-17.

Typical

2 genesThe most common result. The medications that depend only on these genes should work as expected.
  • CYP2B6

    Breaks down efavirenz, ketamine, methadone and some drugs for depression.

    Normal metabolizer*1/*1 · Both copies work normally.
    1 medicationGuidance unchanged
    CYP2B6 normal metabolizer: estimated in 13.0% to 48.6% of people across population groups

    These CPIC estimates describe this phenotype, not your exact DNA combination or your chance of side effects. Frequencies vary by population; no ancestry is assumed for you.

    African American/Afro-Caribbean
    33.4%
    Central/South Asian
    42.2%
    East Asian
    48.6%
    European
    43.0%
    Latino
    33.6%
    Near Eastern
    29.1%
    Oceanian
    13.0%
    Sub-Saharan African
    14.3%

    Estimated from published allele frequencies, rather than a direct count of people with this result. Study coverage and methods vary. Reference: CPIC CYP2B6 frequency table and methods. Data retrieved 2026-10-17.

  • CYP3A4

    Breaks down more prescription drugs than any other enzyme.

    Normal metabolizer*1/*1 · Both copies work normally.
    1 medicationGuidance unchanged

Not in your Psychiatric Report

92 more medications in the Full Report

The Full Report reads 26 more genes from the same 23andMe file and checks prescription medications in 25 groups, including pain relievers, cancer drugs and anesthetics.

  • Movement disorders3
  • Anticonvulsants4
  • Pain management13
  • Cardiovascular7
  • Cholesterol medications7
  • Antiemetics4
  • Proton pump inhibitors4
  • Oncology13
  • Immunosuppressants4
  • Antivirals5
  • Antifungals1
  • Anesthetics8
  • Weight management3
  • Antidiabetics1
  • Antihistamines1
  • Drugs used in addictive disorders1
  • Female sexual health1
  • Gaucher's disease treatments1
  • Gout1
  • Hair loss1
  • Saliva production stimulators1
  • Urologicals1
  • Other substances7
Get your Full Report What's in the Full Report

About this report

What it covers, where the guidance comes from, and what the data can and can't show.

What's in it

28 medications, 3 groups, 4 genes

Psychiatric Report, version 4.6. Made Nov 8, 2026 from a 23andMe file.

This report includes information about how your pharmacogenetics may influence your response to drugs used for psychiatric purposes, including but not limited to depression, bipolar disorder, schizophrenia, and ADHD. This report does not contain information about all drugs used for psychiatric purposes, only those that have known pharmacogenetic interactions. A medication missing from this report may still have guidance from a clinical guideline or product label.

What's new in version 4.6Download the PDFOpen the original layout

What the data can show

  • All 4 genes have a clear result from the 23andMe data, with missing positions filled in from a reference panel.
  • 28 medications have a result.
  • CYP2D6 copy number isn't measured. Extra or missing copies can change CYP2D6 results.
  • Rare variants can be missed. Arrays test selected positions; imputation helps fill the gaps but can still miss rare variants.

Where the guidance comes from

Every medication names its source, and some have more than one. Gene2Rx is not affiliated with or endorsed by CPIC, the FDA or DPWG.

  • CPICClinical Pharmacogenetics Implementation Consortium. Peer-reviewed prescribing guidelines.15 medications
  • DPWGDutch Pharmacogenetics Working Group. Prescribing guidelines used across Europe.8 medications
  • FDAU.S. Food and Drug Administration. Pharmacogenetic information in drug labels.13 medications

How we read your DNA

  1. Step 1

    We fill in positions your array didn't test by comparing your data with a large reference panel.

  2. Step 2

    We name the two copies of each gene you inherited, such as *1/*2.

  3. Step 3

    We look up what that pair means in published tables, then match it to each medication's guidance.

Questions

What do I do now?
If you may have an unusual response to a medication you take or are thinking about taking, talk with your healthcare provider or a genetic counselor before making any changes. The sources linked beside each finding explain its evidence and limits. Not every finding supports a treatment change.
Should I change medications or my dose based on this report?
No. Don't change a dose or stop a medication without talking to your healthcare provider first. Consumer DNA data is not clinical grade, so use this report to start a conversation with your provider, who may order a clinical lab test. Read more about consumer tests and the research behind this advice.
Are these expert annotations?
Each finding names its source. This report includes CPIC, FDA, DPWG and Gene2Rx interpretations, with different levels of evidence. Those organizations don't endorse Gene2Rx's own interpretations, which explain the research behind a finding and its limits.
Why would my results change?
Your genes don't change, but research does. Guidelines and drug labels are updated when new research meets strict standards and experts agree. Your report keeps the guidance used when it was made; an updated report can use newer guidance.
I don't see my medication. Why not?
Not every medication is affected by genetics, and some need more research before guidance exists. A medication can also be missing because of your report tier, your data or what this report covers. A missing medication may still have guidance from a clinical guideline or a drug label.
Does Gene2Rx check CYP2D6 copy number?
No. Gene2Rx doesn't measure CYP2D6 copy number (deletions and duplications of the gene), which can change how you respond to drugs CYP2D6 handles.

More questions? Email contact@gene2rx.com.

This is not a clinical test. Results are predictions from consumer DNA data and published research. They may be wrong. Don't change or stop a medication without talking to your prescriber, and confirm any result that matters with a clinical-grade test.

Gene2Rxgene2rx.com · Pharmacogenetics

Example report · Complete report for your doctor or pharmacist

Psychiatric Report

Prepared for Leslie Knope

Report version
4.6
Created
Nov 8, 2026
Data source
23andMe
Genome build
GRCh37

28 medications · 4 genes · 3 drug classes

This complete edition includes every gene result and every medication in this report tier, including results labeled “Use as directed,” all source guidance, evidence levels and limitations.

This is not a clinical test. Results are predictions from consumer DNA data and published research. The quality of submitted data is not independently verified and errors can affect the report. Do not change a dose or stop a medication without talking to your prescriber. Confirm any result that matters with a clinical-grade test.

Coverage depends on your data and report tier. A medication missing from this report may still have guidance from a clinical guideline or product label.

Reading the guidance

Consider alternative 9
Use with caution 18
Use as directed 1
Unable to determine 0

Use as directed: no change suggested by the assessed genetic findings. Use with caution: a dose change, slower titration or monitoring may be suggested. Consider alternative: discuss another medication or the source’s dose advice. Unable to determine: the available data could not establish a result. These labels do not guarantee effectiveness or freedom from side effects.

Gene2RxCompact report · Example

Psychiatric Report

Prepared for Leslie Knope · Nov 8, 2026 · Version 4.6

23andMe · GRCh37 · 4 genes · 28 medications

All results, summarized. Use the detailed report for full source recommendations, evidence, dose calculations and frequencies. Sources may offer different advice.

Not a clinical test. Do not change or stop a medication without your prescriber. Confirm important findings with a clinical-grade test. Missing or undetermined results do not mean normal results.

Gene results

GeneCopiesGenotypePhenotypeScore
CYP2B6*1/*1Normal Metabolizer-
CYP2C19*1/*2Intermediate Metabolizer-
CYP2D6*4/*4Poor Metabolizer0.0
CYP3A4*1/*1Normal Metabolizer-

Score: gene activity score, where defined. Glyph fill shows each copy’s function; color shows the overall phenotype. Full explanations and typical activity ranges are in the detailed report.

Color shows the overall gene result. Dot fill shows each copy’s function; lettered dots show your DNA letters where copy function isn’t defined.

  • Normal / typical / favorable
  • Intermediate / decreased
  • Poor / increased risk
  • Rapid / increased
  • Not determined

All medications

Summaries describe the report’s overall guidance. “Use as directed” does not guarantee effectiveness or freedom from side effects. Brand names are shown where available.

Summaries use Gene2Rx wording. Summary sources: CPIC = Clinical Pharmacogenetics Implementation Consortium; DPWG = Dutch Pharmacogenetics Working Group; FDA = U.S. Food and Drug Administration drug information; Gene2Rx = research summary. “Report note” is a report explanation without a source summary. See the detailed report for all sources and recommendations.

CYP2D6 copy number is not measured. Arrays test selected positions; imputation helps fill gaps but can still miss rare variants.

Antidepressants 14

MedicationGuidanceGenesSummary
VenlafaxineEffexor XR Consider alternative CYP2D6Your body breaks down this drug much more slowly, which has been linked to more side effects. A different antidepressant may be a better choice. (Summarized from CPIC)
CitalopramCelexa Use with caution CYP2C19Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly. (Summarized from CPIC)
EscitalopramLexapro Use with caution CYP2C19Your body may break down the drug more slowly, increasing side effects. Your doctor may use a lower dose or adjust it more slowly. (Summarized from CPIC)
FluvoxamineLuvox Use with caution CYP2D6Your body breaks down this drug much more slowly. A lower starting dose, a slower increase, or a different drug may be safer. (Summarized from CPIC)
ParoxetinePaxil, Seroxat Use with caution CYP2D6Your body processes this drug very slowly, so you may need half the usual dose to avoid side effects. (Summarized from CPIC)
SertralineZoloft Use with caution CYP2C19CYP2B6Your body processes this drug a bit more slowly. You can start at the usual dose, but your doctor may raise it slowly, and a lower ongoing dose may be enough. (Summarized from CPIC)
VortioxetineTrintellix, Brintellix Use with caution CYP2D6Your body clears this drug much more slowly. Half the usual starting dose is advised, or a different antidepressant. (Summarized from CPIC)
AmitriptylineElavil Consider alternative CYP2D6CYP2C19Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested. (Summarized from CPIC)
ClomipramineAnafranil Consider alternative CYP2D6CYP2C19Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested. (Summarized from CPIC)
DesipramineNorpramin Consider alternative CYP2D6Your body breaks down this drug much more slowly, so it can build up and cause side effects. A different medicine is usually suggested. (Summarized from CPIC)
DoxepinSinequan, Quitaxon, Aponal Consider alternative CYP2D6CYP2C19Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested. (Summarized from CPIC)
ImipramineTofranil Consider alternative CYP2D6CYP2C19Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested. (Summarized from CPIC)
NortriptylinePamelor Consider alternative CYP2D6Your body breaks down this drug very slowly, so it builds up and side effects are more likely. A different drug is usually suggested. (Summarized from CPIC)
TrimipramineSurmontil Consider alternative CYP2D6CYP2C19Your two genes together change how your body handles this drug. It may cause more side effects or not work as well, so a different antidepressant is often suggested. (Summarized from CPIC)

Antipsychotics 12

MedicationGuidanceGenesSummary
AripiprazoleAbilify Use with caution CYP2D6Your body clears aripiprazole slowly, so more of it builds up and side effects are more likely. A lower maximum dose is advised. (Summarized from DPWG)
Aripiprazole LauroxilAristada Use with caution CYP2D6Your body breaks down aripiprazole lauroxil more slowly than normal, causing higher levels of the drug in your system. A lower dose is recommended to reduce the risk of side effects. (Summarized from FDA)
BrexpiprazoleRexulti Use with caution CYP2D6Your body clears brexpiprazole slowly, so more of it builds up. Half the usual dose is advised. (Summarized from DPWG)
ClozapineClozaril Use with caution CYP2D6Your body breaks down clozapine much more slowly than normal, causing the drug to build up to higher levels in your system. A lower dose may be needed to reduce the risk of side effects. (Summarized from FDA)
HaloperidolHaldol Use with caution CYP2D6Your body clears haloperidol slowly, which raises the concentration in your blood and increases side effect risk. A lower dose is typically recommended. (Summarized from DPWG)
IloperidoneFanapt Use with caution CYP2D6Your body breaks down iloperidone much more slowly than normal, causing the drug to build up and increasing the risk of heart rhythm problems. The dose should be cut in half. (Summarized from FDA)
PerphenazineTrilafon Use with caution CYP2D6Your body breaks down perphenazine much more slowly than normal, causing the drug to build up in your system. This increases your risk of side effects. (Summarized from FDA)
PimozideOrap Use with caution CYP2D6Your body clears pimozide slowly, which could raise the risk of heart rhythm side effects. Half the usual maximum dose is advised. (Summarized from DPWG)
QuetiapineSeroquel Use as directed CYP3A4Your CYP3A4 gene works normally, so the standard dose of this drug is used. (Summarized from DPWG)
RisperidoneRisperdal Use with caution CYP2D6Your body clears risperidone slowly, so more of it builds up and side effects are more likely. About two-thirds of the usual dose is advised, and less if side effects still occur. (Summarized from DPWG)
ThioridazineMellaril Consider alternative CYP2D6Your body breaks down thioridazine much too slowly, causing dangerous levels to build up. This significantly increases your risk of serious heart rhythm problems. This medication should not be used. (Summarized from FDA)
ZuclopenthixolClopixol Use with caution CYP2D6Your body clears this drug slowly, so it builds up in your blood. Half the usual dose is advised. (Summarized from DPWG)

Psychostimulants 2

MedicationGuidanceGenesSummary
AmphetamineAdzenys ER Use with caution CYP2D6Your body breaks down amphetamine much more slowly than normal, which may cause the drug to build up and increase your risk of side effects. A lower dose or a different medication may be needed. (Summarized from FDA)
AtomoxetineStrattera Use with caution CYP2D6Your body processes this drug very slowly, so it builds up. It may work well but cause more side effects, so your doctor may start low and go slowly. (Summarized from CPIC)

Coverage depends on your data and report tier. A medication missing here may still have pharmacogenetic guidance. Full source text and references are in the detailed report. Questions: contact@gene2rx.com.