Současnost a perspektivy farmakogenetiky v léčbě psychóz
| Title in English | The presence and perspectives of pharmacogenetics of antipsychotic treatment |
|---|---|
| Authors | |
| Year of publication | 2011 |
| Type | Article in Periodical |
| Magazine / Source | Česká a slovenská psychiatrie |
| MU Faculty or unit | |
| Citation | |
| Field | Pharmacology and pharmaceutical chemistry |
| Keywords | genetic testing; pharmacogenetics; psychotic disorders |
| Description | Pharmacogenetics is a scientific discipline seeking for associations between the genetic code of the patient and his or her treatment effectiveness or drug adverse effects. It should contribute to a better individuation of pharmacotherapy, including antipsychotics. Contemporary research of antipsychotic drugs is aimed at pharmacokinetics as well as pharmacodynamics. Our knowledge on polymorphisms of the genes for the liver isoenzymes CYP1A2, CYP2D6 and the CYP3A group seems to be promising. Pharmacodynamic studies were mostly related to clozapine and other second generation antipsychotics in a relation to polymorphisms in the genes for dopaminergic, serotonergic, epinephrine and norepinephrine receptors and transporters, likewise catechol-O-methyltransferase and glutamate receptors. Unfortunately, most of the results of research are still inconsistent. This may be due to variables concerning the sample of the patients, genetic assays, environmental factors, choice of antipsychotic medication, study procedures or statistical analysis. Pharmacokinetic tests appear to be more useful for a clinical practice than pharmacodynamic ones. Perspectives of a further advancement of pharmacogenetics (not only) in antipsychotics appear to be hopeful, but apart from DNA, it is also necessary to consider RNA, intracellular proteins, epigenetics, endophenotypes, clinical features and environmental factors. It is also meaningful to simultaneously use other research techniques, e.g. electroencephalography, neuropsychology or brain imaging. In this way, the number of patients inevitable for finding a true genetic association may fall from thousands or hundreds to tens. |