The Zucker Hillside Hospital, Feinstein Institute of Medical Research, North Shore-Long Island Jewish Health System, Division of Psychiatry Research, Department of Psychiatry, Glen Oaks, NY 11004, USA.
Expert Opin Drug Metab Toxicol. 2011 Jan;7(1):9-37. doi: 10.1517/17425255.2011.532787.
Antipsychotic drug is the mainstay of treatment for schizophrenia, and there are large inter-individual differences in clinical response and side effects. Pharmacogenetics provides a valuable tool to fulfill the promise of personalized medicine by tailoring treatment based on one's genetic markers.
This article reviews the pharmacogenetic literature from early 1990s to 2010, focusing on two aspects of drug action: pharmacokinetics and pharmacodynamics. Genetic variants in the neurotransmitter receptors including dopamine and 5-HT and metabolic pathways of drugs including CYP2D6 and COMT were discussed in association with clinical drug response and side effects.
Readers are expected to learn the up-to-date evidence in pharmacogenetic research and to gain familiarity to the issues and challenges facing the field.
Pharmacogenetic research of antipsychotic drugs is both promising and challenging. There is consistent evidence that some genetic variants can affect clinical response and side effects. However, more studies that are designed specifically to test pharmacogenetic hypotheses are clearly needed to advance the field.
抗精神病药物是治疗精神分裂症的主要手段,在临床反应和副作用方面存在着很大的个体差异。药物遗传学提供了一个有价值的工具,通过根据一个人的遗传标记来调整治疗,从而实现个性化医疗的承诺。
本文回顾了 20 世纪 90 年代初到 2010 年的药物遗传学文献,重点讨论了药物作用的两个方面:药代动力学和药效动力学。讨论了包括多巴胺和 5-HT 在内的神经递质受体以及包括 CYP2D6 和 COMT 在内的药物代谢途径的遗传变异与临床药物反应和副作用的关系。
读者将了解到药物遗传学研究的最新证据,并熟悉该领域面临的问题和挑战。
抗精神病药物的药物遗传学研究既有希望也有挑战。有一致的证据表明,一些遗传变异可以影响临床反应和副作用。然而,显然需要更多专门设计来检验药物遗传学假设的研究来推进该领域。