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抗精神病药物治疗反应和副作用的药物遗传学

Pharmacogenetics of antipsychotic treatment response and side effects.

作者信息

Mackenzie B, Souza Rp, Likhodi O, Tiwari Ak, Zai Cc, Sturgess J, Müller Dj

机构信息

Neurogenetics Section, Neuroscience Department Centre for Addiction & Mental Health, Toronto, ON, Canada Tel: +1416 535 8501 ext. 6851 Fax:+1 416 979 4666.

出版信息

Therapy. 2010 Mar;7(2):191-198. doi: 10.2217/thy.10.3.

Abstract

Antipsychotic drugs are particularly interesting in pharmacogenetic studies as they are associated with a large interindividual variability in terms of response and side effects and, therefore, frequently need to be discontinued, requiring switches to other antipsychotics. Any information that allows the prediction of outcome to a given antipsychotic in a particular patient will, therefore, be of great help for the clinician to minimize time and find the right drug for the right patient, thus optimizing response and minimizing side effects. This will also have a substantial impact on compliance and doctor-patient relationships. Moreover, antipsychotic drug treatments are often required for life-long treatment and are also frequently prescribed to the more 'vulnerable' populations: children, adolescents and the elderly. This article focuses on some important studies performed with candidate gene variants associated with antipsychotic response. In addition, important findings in pharmacogenetic studies of antipsychotic-induced side effects will be briefly summarized, such as antipsychotic treatment induced tardive dyskinesia and weight gain.

摘要

抗精神病药物在药物遗传学研究中特别引人关注,因为它们在反应和副作用方面存在很大的个体间差异,因此常常需要停药,并转而使用其他抗精神病药物。因此,任何能够预测特定患者对某种抗精神病药物治疗结果的信息,都将极大地帮助临床医生缩短治疗时间,为合适的患者找到合适的药物,从而优化治疗反应并减少副作用。这也将对患者的依从性以及医患关系产生重大影响。此外,抗精神病药物治疗通常需要终身进行,而且也经常被开给更“脆弱”的人群:儿童、青少年和老年人。本文重点介绍了一些针对与抗精神病药物反应相关的候选基因变异所开展的重要研究。此外,还将简要总结抗精神病药物所致副作用的药物遗传学研究中的重要发现,如抗精神病药物治疗引起的迟发性运动障碍和体重增加。

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