Pharmacogenetics and Psychiatry

Abstract

Genetic factors play a significant role in predicting an individual's response to a drug. The response may be the desired therapeutic effect of the drug and also may be the undesirable development of adverse effects. This relationship between genes and drug response interests the pharmacogeneticist. This article aims to give an overview of the exciting discoveries made so far in the field of psychiatry, particularly concerning the response to antidepressants and antipsychotics, as well as to mention some of the more recent findings. The ultimate goal of pharmacogenetics is to provide medication "tailored" to the individual based on their genetic profile, and although this may currently seem a distant target, it has already begun to raise ethical questions, which also are discussed.

Clinical relevance of discoveries in psychopharmacogenetics1

“…Acute akathisia has also been reported to be associated with polymorphisms in DRD3 and DRD2 (Basu et al, 2004b). MnSOD alone has also been shown to be weakly associated with tardive dyskinesia.…”

Psychiatry and the ‘new genetics’: hunting for genes for behaviour and drug response

“…This is dependent on a range of different factors, including age, organ function (in particular, renal and hepatic), psychological factors (most apparent in the placebo response), drug interaction and genetic factors. Pharmacogenetics is concerned with the role of genetic factors in predicting both drug response and potential adverse effects (Basu et al , 2004). The pre-genomic era saw the study of how variants at the DNA level related to drug response.…”

The bio-distribution of the antidepressant clomipramine is modulated by chronic stress in mice: effects on behavior

“…For example, improved therapeutic outcome is associated with higher serum levels of CMI and DCMI as well as a higher metabolic ratio of CMI to DCMI (Szegedi et al, 1996 ). To-date, diverging pharmacokinetic factors and clinical responses to CMI observed amongst patients have been largely attributed to genetic factors (Basu et al, 2004 ; Kirchheiner et al, 2004 ). Identification of environmental factors that predict drug efficacy and/or patient response remains largely elusive despite the potential clinical implications.…”