Pharmacogenomics has the potential to transform how medicines are prescribed. We will discuss our experience of implementing pharmacogenomics in two pilot projects. Both projects focussed on mental health medications. The most recent project was carried out in secondary care, and the earlier project was performed in primary care. We will present overviews of both projects, demonstrating how pharmacogenomic testing for depression works, what results were obtained and if they are sustainable at 4 years. Reviewing the impact this has on patient care and posing a challenge to the audience.