Skryabin VYu, Petukhov A E, Pozdniakov S A, Ivanchenko V A, Zaytsev I A, Miroshkin S S, Sokolova S I, Bure I V, Smirnov V V, Sychev D A
Skryabin, PhD, MD, head of clinical department, Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow, Russia; Associate professor of addiction psychiatry department, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
Petukhov, PhD, MD, clinical laboratory diagnostician of the analytical toxicology lab of the Reference center for psychoactive substances use monitoring, Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow, Russia.
Psychopharmacol Bull. 2025 Jan 1;55(1):37-46.
Alcoholic hallucinosis (AH) is one of the severe complications of chronic alcoholism, characterized by psychotic symptoms such as auditory hallucinations and delusions. Haloperidol is widely used to treat AH; however, its therapy is often complicated by side effects. A personalized approach using pharmacogenetic testing (particularly the CYP2D6 polymorphism) allows individualization of haloperidol dosage, improving both safety and efficacy of therapy.
The study included 100 men diagnosed with "psychotic disorder induced by alcohol use." Patients were randomized into two groups: the main group (45 patients) received haloperidol based on the results of pharmacogenetic testing, while the control group (55 patients) received standard dosing. Genotyping was conducted for the CYP2D6 1846G > A polymorphism. The effectiveness was assessed using the PANSS, UKU, and SAS scales.
Genotyping showed an even distribution of CYP2D6 polymorphisms in both groups. The main group demonstrated a significant reduction in side effects and improvement in psychotic symptoms compared to the control group. Differences on the UKU, SAS, and PANSS scales reached statistical significance on days 3-5 of treatment.
Using pharmacogenetic testing to adjust haloperidol dosage improves therapy tolerability and accelerates the resolution of psychotic symptoms in patients with alcoholic hallucinosis, confirming the feasibility of a personalized approach in psychopharmacotherapy.
酒精性幻觉症（AH）是慢性酒精中毒的严重并发症之一，其特征为出现如幻听和妄想等精神病性症状。氟哌啶醇被广泛用于治疗AH；然而，其治疗常因副作用而变得复杂。采用药物遗传学检测（尤其是CYP2D6基因多态性）的个性化方法可实现氟哌啶醇剂量的个体化，提高治疗的安全性和有效性。
该研究纳入了100名被诊断为“酒精使用所致精神障碍”的男性患者。患者被随机分为两组：主要组（45例患者）根据药物遗传学检测结果接受氟哌啶醇治疗，而对照组（55例患者）接受标准剂量治疗。对CYP2D6 1846G＞A基因多态性进行基因分型。使用阳性和阴性症状量表（PANSS）、乌普萨拉监测表（UKU）和焦虑自评量表（SAS）评估疗效。
基因分型显示两组中CYP2D6基因多态性分布均匀。与对照组相比，主要组的副作用显著减少，精神病性症状有所改善。在治疗第3至5天，UKU、SAS和PANSS量表上的差异达到统计学意义。
使用药物遗传学检测来调整氟哌啶醇剂量可提高酒精性幻觉症患者治疗的耐受性，并加速精神病性症状的缓解，证实了精神药物治疗中个性化方法的可行性。
