In routine clinical practice, PGx testing is preferentially used in youth and adults with clinically complex histories and is associated with shifts in antidepressant prescribing patterns. Exploratory findings suggest hypothesis-generating signals of reduced psychiatric ED utilisation among patients with higher psychiatric complexity, which requires further confirmation. Observed racial disparities highlight the need for earlier and more equitable implementation. Prospective studies incorporating symptom-level and safety outcomes are needed to determine whether PGx-guided prescribing translates into meaningful clinical benefit.

