Pharmacogenetic Applications and Pharmacogenomic Approaches in Schizophrenia

Abstract

Several genetic factors have been identified that, in combination with clinical and environmental factors, contribute to the variability in response to treatment with antipsychotic drugs. Functional polymorphisms in genes coding for cytochrome-P450 (CYP) enzymes, responsible for the metabolism of over 85 % of drugs, have been associated with the development of drug-induced side-effects, and functional polymorphisms in dopamine and serotonin genes may be associated with adverse reactions and treatment efficacy. Recent estimations have suggested that selecting the drug and clinical dose according to the patient's genetic profile may result in a significant improvement of treatment efficacy (10-15 %) and safety (15-20 %). This information has prompted the development of commercial kits to facilitate the clinical application of pharmacogenetic information. However, prospective studies confirming the clinical and economical benefits of these tests are required before their widespread implementation in clinical practice.

Pharmacogenetics and Antipsychotic Treatment Response/ Фармакогенетски Тестирања И Одговор Кон Третман Со Антипсихотоци

“…Among the SNPs of DRD3 gene, the most interesting variant which is extensively studied is Gly9Ser. The 9Gly variant confers higher binding affinity and better antipsycho-tics response regarding the positive symptoms, but it also increases the risk of tardive dyskinesia [5,80,81].…”

“…Early treatment response and significant weight gain are signs of a good prognosis. On the other hand, early age onset of disease and the presence of EPS are linked with a poor pharmacological treatment response [5]. A high percentage of patients with schizophrenia respond poorly to antipsychotic treatment, or present refractory schizophrenia.…”