Eum Seenae, Lee Adam M, Bishop Jeffrey R
College of Pharmacy, Department of Experimental and Clinical Pharmacology; University of Minnesota, Minneapolis, Minnesota, USA.
College of Pharmacy, Department of Experimental and Clinical Pharmacology; College of Medicine, Department of Psychiatry; University of Minnesota, Minneapolis, Minnesota, USA.
Dialogues Clin Neurosci. 2016 Sep;18(3):323-337. doi: 10.31887/DCNS.2016.18.3/jbishop.
Optimizing antipsychotic pharmacotherapy is often challenging due to significant variability in effectiveness and tolerability. Genetic factors influencing pharmacokinetics and pharmacodynamics may contribute to some of this variability. Research studies have characterized these pharmacogenetic relationships, and some genetic markers are now available as clinical tests. These advances in pharmacogenetics research and test availability have great potential to improve clinical outcomes and quality of life in psychiatric patients. For clinicians considering using pharmacogenetics, it is important to understand the clinical implications and also the limitations of markers included in currently available tests. This review focuses on pharmacokinetic and pharmacodynamic gene variants that are currently available in commercial genetic testing panels. Associations of these variants with clinical efficacy and adverse effects, as well as other clinical implications, in antipsychotic pharmacotherapy are discussed.
由于有效性和耐受性存在显著差异，优化抗精神病药物治疗往往具有挑战性。影响药物代谢动力学和药效动力学的遗传因素可能是造成这种差异的部分原因。研究已经明确了这些药物遗传学关系，现在一些基因标记可作为临床检测手段。药物遗传学研究的这些进展以及检测手段的可用性，对于改善精神科患者的临床结局和生活质量具有巨大潜力。对于考虑使用药物遗传学的临床医生来说，了解当前可用检测中所包含标记的临床意义及其局限性非常重要。本综述重点关注商业基因检测面板中目前可用的药物代谢动力学和药效动力学基因变异。讨论了这些变异与抗精神病药物治疗中的临床疗效、不良反应以及其他临床意义之间的关联。
