Department of Psychiatry, Inje University Busan Paik Hospital.
Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine.
Int Clin Psychopharmacol. 2024 Jan 1;39(1):29-35. doi: 10.1097/YIC.0000000000000501. Epub 2023 Aug 7.
This study explored the association of pharmacogenomics with antipsychotic-induced amenorrhea in female patients with schizophrenia. A total of 89 female schizophrenia patients aged 18-40 receiving consistent antipsychotics at a consistent dose for more than 3 months were enrolled in this study. Amenorrhea was defined as the absence of menstrual period for 3 months or three periods in a row. Serum levels of prolactin, estradiol, follicle-stimulating hormone, luteinizing hormone, and thyroid-stimulating hormone were measured and Cytochrome P450 2D6, dopamine receptor D2 ( DRD2 ) and estrogen receptor 1 were genotyped. Twenty-two patients with amenorrhea had higher prolactin levels and lower estradiol levels than those without amenorrhea (94.1 vs. 71.5 ng/ml for prolactin; P = 0.044 and 27.0 vs. 46.7 pg/ml for estradiol; P = 0.007, respectively). Multiple logistic regression analysis identified DRD2 -141C deletion [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.01-4.17; P = 0.049] and drugs increasing prolactin levels (OR = 6.17, 95% CI = 1.28-29.64; P = 0.023) as significant covariates for antipsychotic-induced amenorrhea. This study suggests that DRD2 -141C deletion is associated with antipsychotic-induced amenorrhea although further studies are needed.
本研究探讨了药物基因组学与女性精神分裂症患者抗精神病药引起的闭经之间的关系。共纳入 89 名年龄在 18-40 岁之间、接受稳定剂量抗精神病药物治疗超过 3 个月的女性精神分裂症患者。闭经定义为连续 3 个月或 3 个周期无月经。测量催乳素、雌二醇、卵泡刺激素、黄体生成素和促甲状腺激素的血清水平，并对细胞色素 P450 2D6、多巴胺受体 D2 (DRD2) 和雌激素受体 1 进行基因分型。22 例闭经患者的催乳素水平高于无闭经患者（催乳素分别为 94.1 和 71.5ng/ml；P=0.044 和雌二醇分别为 27.0 和 46.7pg/ml；P=0.007）。多因素 logistic 回归分析发现 DRD2-141C 缺失[比值比（OR）=1.71，95%置信区间（CI）=1.01-4.17；P=0.049]和增加催乳素水平的药物[OR=6.17，95%CI=1.28-29.64；P=0.023]是抗精神病药引起闭经的显著协变量。本研究表明，尽管还需要进一步研究，但 DRD2-141C 缺失与抗精神病药引起的闭经有关。
