Mamdani F, Groisman I Jaitovich, Alda M, Turecki G
Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada.
Pharmacogenomics J. 2004;4(3):161-70. doi: 10.1038/sj.tpj.6500245.
Bipolar disorder (BD) is a major psychiatric condition that commonly requires prophylactic and episodic treatment. There is important variability in the therapeutic response and side-effect profiles to currently available pharmacological agents. Pharmacogenetics have provided new hopes to develop more efficient treatment strategies tailored to the individual patient's needs. This review assesses nonsystematically studies using pharmacogenetic strategies in BD. Most of these studies have focused on patients selected according to lithium response, and more recently, a growing number of studies have been investigating genetic factors in mixed samples of patients classified according to response to antidepressant treatment. Although previous clinical and family studies support the use of pharmacogenetic strategies both to increase phenotype homogeneity as well as to identify genetic factors that may mediate response to treatment, most molecular studies carried out to date are still preliminary and in need of external validation. A major problem has been comparability between studies, in part, because of differences in the criteria used to define response. More attention should be paid to standardize the criteria for drug response definition.
双相情感障碍（BD）是一种主要的精神疾病，通常需要进行预防性和发作期治疗。目前可用的药物治疗在疗效和副作用方面存在重要差异。药物遗传学为制定更符合个体患者需求的高效治疗策略带来了新希望。本综述非系统地评估了双相情感障碍中使用药物遗传学策略的研究。这些研究大多集中在根据锂反应选择的患者身上，最近，越来越多的研究开始调查根据抗抑郁治疗反应分类的患者混合样本中的遗传因素。尽管先前的临床和家族研究支持使用药物遗传学策略来提高表型同质性以及识别可能介导治疗反应的遗传因素，但迄今为止进行的大多数分子研究仍处于初步阶段，需要外部验证。研究之间的可比性一直是一个主要问题，部分原因是用于定义反应的标准存在差异。应更加重视规范药物反应定义的标准。
