The Role of Pharmacogenetics in Treating Central Nervous System Disorders

Abstract

Symptoms of central nervous system (CNS) disorders include abnormalities in both physical and psychological domains. Many drugs indicated for the treatment of CNS disorders are fraught with side effects and/or poor efficacy which impact patients' quality of life and drives non-compliance. Moreover, for many CNS drugs such as antidepressants and antipsychotics, it takes time to determine whether a particular drug is efficacious in an individual patient. To optimize drug treatment for each patient, prescribing physicians often need to raise or lower doses, switch drug classes, or prescribe additional drugs to mitigate side effects, often in a "trial and error" fashion. Pharmacogenetic (PGx) testing, particularly in the realm of CNS therapy, can reduce the unpredictability of this process. By determining a patient's genetic profile, individual therapy parameters may be predicted pre-treatment for drug efficacy, optimal drug dose, and the risk of adverse drug reactions (ADRs). The intent of this review is to highlight the power of PGx testing to predict the likelihood of ADRs and efficacy during the treatment of the following CNS disorders: epilepsy, bipolar disorder, schizophrenia and depression.

Utilisation de la pharmacogénomique et de la pharmacogénétique à l’unité de soins intensifs: un compte rendu narratif

“…The prevalence of HLA-B*1502 is highest in the Han Chinese, and that of carbamazepine-induced SJS and TEN is highest in this population as well. 179 The HLA-B*1502 allele has also been implicated in phenytoin-induced SJS/TEN in Han Chinese and Thai populations. 178,180 Carbamazepine hypersensitivity reactions (fever, eosinophilia) are more frequent in individuals who have at least one of three SNPs localized at the heat shock protein locus (two in HSP70-1 and one in HSP-Hom).…”