Pharmacogenetic-Guided Antidepressant Prescribing in Adolescents With Anxiety and Depression

This is a parallel arm randomized (1:1) controlled trial. Adolescents aged 12-17 years (n=228) who are starting or changing a selective serotonin reuptake inhibitor (SSRI) for depression and/or anxiety will be randomly allocated to receive 12-weeks of pharmacogenetic-guided antidepressant therapy (experimental intervention) or current prescribing guidelines/recommendations guided therapy (control intervention).

Inclusion Criteria: * Age 12-17 * Depression and/or anxiety as the primary concern, confirmed by the treating physician * Intention to start a new SSRI * English fluency Exclusion Criteria: * Co-occurring obsessive compulsive disorder, psychosis, bipolar disorder, eating disorder, autism spectrum disorder, fetal alcohol spectrum disorder, or intellectual disability * History of non-response to 3 or more SSRI medications as confirmed by the treating physician * Brain stimulation-based therapy initiated within 8 weeks of referral, or plans to initiate/change brain stimulation during study participation * History of liver or hematopoietic cell transplant * History of CYP2B6, CYP2C19, or CYP2D6 testing