The role of pharmacogenomics in the discontinuation of psychotropic medication: a scoping review protocol

The paper describes a protocol of a scoping review which is aimed at undertaking the literature review of the role of pharmacogenomics in psychotropic medication discontinuation. The subject is applicable and timely, particularly considering that there is growing awareness regarding withdrawal symptoms, relapse, and individual differences during the discontinuation of psychotropic drugs. Pharmacogenomics is already widely utilized in the field of drugs selection and dose adjustment, but the area of pharmacogenomics in deprescribing and drug discontinuation remains poorly studied, and the given protocol attempts to fill the gap in a significant manner.

The justification of the study is well stated. The background section is sufficient to describe the clinical issues related to the discontinuation of psychotropic drugs and presents a sensible argument as to why genetic differences can affect the discontinuation process. The aims of the review are clearly designed and logically developed out of the background. The application of the Population-Concept-Context framework to formulate the review question is suitable and assists in keeping the focus.

The research question is appropriate to the overall study design. The scoping review is a valid option, as the topic under discussion is exploratory in nature, and the range of possible study designs, drug classes, and genetic markers is likely to be diverse. The aim to adhere to Joanna Briggs Institute methodology and report in line with PRISMA-ScR is suitable and demonstrates the knowledge of the best practices related to conducting scoping reviews. The choice of not conducting formal quality appraisal is agreeable to this kind of review.

The methods section is generally clear, although there are parts that are described not fully and could be clarified. The search databases that it uses are suitable, and it includes an example search strategy that enhances transparency. Nonetheless, the protocol fails to explicitly state the time range of the literature search, e.g., the studies will be included in the database since its inception to a certain end date. This is to be brought out clearly. There is also no mention of language restrictions and it is not specified whether non-English studies are going to be included or not. This is something that should be clarified to eliminate confusion. Besides that, it is also mentioned in the protocol that grey literature will not be used, but the reasons behind this choice are not brought forth. Since the research in pharmacogenomics is dynamic, a concise explanation of why grey literature was not included would be a reinforcement to the methods section. Additional information on how the changes in the form of data charting would be addressed and reported throughout the review process would enhance reproducibility as well.

Since this is a protocol, no datasets are given and consequently data presentation assessment is not possible. The authors rightfully report that they do not have any underlying data that are related to the article and offer such supplementary materials as the search strategy and reporting checklist via an open repository, which is useful in terms of transparency.

In order to provide scientific validity of the protocol, the following aspects would be considered: clear-specification of the search time frame, explicit clarification on the inclusion or exclusion criteria based on language and justification of why grey literature would be excluded. Considering these would enhance better methodology but it would not alter the overall purpose of the study.