Tao Hejian, Jin Haiying, Xu Min, Chen Haihan, Sun Fengli, Jin Weidong
Department of Psychiatry, Jinhua Municipal Center Hospital, Jinhua, China.
Department of Psychiatry, Zhejiang Chinese Medical University, Hangzhou, China.
Front Pharmacol. 2024 Nov 26;15:1465356. doi: 10.3389/fphar.2024.1465356. eCollection 2024.
To explore the correlation of the gene polymorphism with psychopathology and predict responses in patients with mania treated with lithium and olanzapine. Sixty patients with bipolar mania were treated with lithium combined with olanzapine for 8 weeks and assessed using YMRS, HAMD, and HAMA. The gene polymorphism rs1800497 was tested. Eleven (24.4%) manic patients achieved an early effective response according to the reduction of the YMRS score of >20% in the 2nd week, with a lower HAMA score than the no early effective response group. Twenty-three (51.1%) manic patients achieved remission according to the reduction of the YMRS score of >75% at the 8th week with a higher dose of lithium at the 8th weekend (g/day) than in the no-remission group. Manic patients with genotype GG had lower YMRS scores and lower doses and serum concentrations of olanzapine than patients with genotype AA + AG from the 4th week to the 8th week. Manic patients with genotype GG had a higher relative change in the YMRS score than those with genotype AA + AG from the 2nd week to the 8th week. No differences in HAMA or HAMD were found between the groups with genotype GG and AA + AG. There were more patients who achieved an early effective response in the 2nd week and remission in the 8th in those with genotype GG compared to those with genotype AA + AG. Manic patients with genotype GG had a greater improvement in the YMRS score due to a greater early effective response and remission, which was not related to higher doses and serum concentrations of olanzapine and lithium.
探讨基因多态性与精神病理学的相关性，并预测锂盐和奥氮平治疗躁狂症患者的反应。60例双相躁狂症患者联用锂盐和奥氮平治疗8周，采用杨氏躁狂量表（YMRS）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）进行评估。检测基因多态性rs1800497。11例（24.4%）躁狂症患者在第2周时YMRS评分降低>20%，达到早期有效反应，其HAMA评分低于未达到早期有效反应组。23例（51.1%）躁狂症患者在第8周时YMRS评分降低>75%，达到缓解，其第8周末锂盐剂量（g/天）高于未缓解组。从第4周至第8周，基因型为GG的躁狂症患者YMRS评分低于基因型为AA + AG的患者，奥氮平剂量和血清浓度也较低。从第2周至第8周，基因型为GG的躁狂症患者YMRS评分的相对变化高于基因型为AA + AG的患者。基因型为GG和AA + AG的两组之间HAMA或HAMD评分无差异。与基因型为AA + AG的患者相比，基因型为GG的患者在第2周达到早期有效反应和第8周达到缓解的人数更多。基因型为GG的躁狂症患者YMRS评分改善更大，这是由于早期有效反应和缓解更明显，且与奥氮平和锂盐的高剂量及血清浓度无关。
