Pharmacogenomic testing has the potential to improve medicines optimisation by providing information on the individual’s response to treatment, improving effectiveness and safety of treatment by reducing the risk of adverse drug reactions (ADRs). People have on average four gene variants that influence medication effectiveness and risk of ADRs, with 99% of individuals having at least one gene variant that affects drug metabolism. The use of pharmacogenomics to guide treatment choices could reduce the likelihood of medication related harm and improve patient outcomes from safer personalised medication regimes. Some studies have shown that this approach could be more cost effective, and that pharmacogenomics can be used to support antidepressant prescribing,132 however more evidence is needed together with a tested framework for implementation.