In psychiatry, the selection of antipsychotics and antidepressants is generally led by a trial-and-error approach. The prescribing of these medications is complicated by sub-optimal efficacy and high rates of adverse drug reactions (ADRs). These both contribute to poor levels of adherence. Pharmacogenetics (PGx) considers how genetic variation can influence an individual’s response to a drug. Pharmacogenetic testing is a tool that could aid clinicians when selecting psychotropic medications, as part of a more personalized approach to prescribing. This may improve the use of and adherence to these medications. Yet to date, the implementation of PGx in mental health environments in the United Kingdom has been slow. This review aims to identify the current barriers and enablers to the implementation of PGx in psychiatry and determine how this can be applied to the uptake of PGx by NHS mental health providers. A systematic searching strategy was developed, and searches were carried out on the PsychInfo, EmBase, and PubMed databases, yielding 11 appropriate papers. Common barriers to the implementation of PGx included cost, concerns over incorporation into current workflow and a lack of knowledge about PGx; whilst frequent enablers included optimism that PGx could lead to precision medicine, reduce ADRs and become a more routine part of psychiatric clinical care. The uptake of PGx in psychiatric care settings in the NHS should consider and overcome these barriers, while looking to capitalize on the enablers identified in this review.

在精神病学中，抗精神病药和抗抑郁药的选择通常采用试错法。这些药物的处方因疗效欠佳和药物不良反应 (ADR) 发生率高而复杂化。这些都导致依从性差。药物遗传学 (PGx) 考虑遗传变异如何影响个体对药物的反应。作为更加个性化的处方方法的一部分，药物遗传学检测是一种可以帮助临床医生选择精神药物的工具。这可能会改善这些药物的使用和依从性。然而，迄今为止，英国精神卫生环境中 PGx 的实施进展缓慢。本综述旨在确定目前在精神病学中实施 PGx 的障碍和促成因素，并确定如何将其应用于 NHS 心理健康提供者对 PGx 的采用。制定了系统的检索策略，并在 PsychInfo、EmBase 和 PubMed 数据库上进行了检索，产生了 11 篇合适的论文。实施 PGx 的常见障碍包括成本、对纳入当前工作流程的担忧以及缺乏对 PGx 的了解；而常见的推动因素包括乐观，即 PGx 可以导致精准医疗、减少 ADR 并成为精神病临床护理的常规部分。在 NHS 的精神科护理环境中使用 PGx 应考虑并克服这些障碍，同时寻求利用本综述中确定的促成因素。