lunes, 4 de noviembre de 2013

Clinical validity of cytochrome P450 metabolism and serotonin gene variants in psychiatric pharmacotherapy, International Review of Psychiatry, Informa Healthcare

Clinical validity of cytochrome P450 metabolism and serotonin gene variants in psychiatric pharmacotherapy, International Review of Psychiatry, Informa Healthcare

Clinical validity of cytochrome P450 metabolism and serotonin gene variants in psychiatric pharmacotherapy
October 2013, Vol. 25, No. 5 , Pages 509-533 (doi:10.3109/09540261.2013.825579)
1AssureRx Health,
Mason, Ohio
2Cedar Associates LLC, Menlo Park,
California
3Stanford University School of Medicine,
Stanford, California
4Department of Psychiatry and Psychology, Mayo Clinic,
Rochester, Minnesota
, USA
Note: Deviation from the APA style in this paper is an exception for the International Review of Psychiatry and not a rule.
Correspondence: C. Anthony Altar, PhD, AssureRx Health, Inc.,
Senior VP and Chief Science Officer, 6030 S. Mason-Montgomery Road, Mason, Ohio 45040
, USA. Tel: (513) 701-5035. Fax: (513) 492-7946. E-mail:


Abstract

Adverse events, response failures and medication non-compliance are common in patients receiving medications for the treatment of mental illnesses. A systematic literature review assessed whether pharmacokinetic (PK) or pharmacodynamic (PD) responses to 26 commonly prescribed antipsychotic and antidepressant medications, including efficacy or side effects, are associated with nucleotide polymorphisms in eight commonly studied genes in psychiatric pharmacotherapy: CYP2D6, CYP2C19, CYP2C9, CYP1A2, CYP3A4, HTR2C, HTR2A, and SLC6A4. Of the 294 publications included in this review, 168 (57%) showed significant associations between gene variants and PK or PD outcomes. Other studies that showed no association often had insufficient control for confounding variables, such as co-medication use, or analysis of medications not substrates of the target gene. The strongest gene–outcome associations were for the PK profiles of CYP2C19 and CYP2D6 (93% and 90%, respectively), for the PD associations between HTR2C and weight gain (57%), and for SLC6A4 and clinical response (54%), with stronger SLC6A4 response associations for specific drug classes (60–83%). The preponderance of evidence supports the validity of analyzing nucleotide polymorphisms in CYP and pharmacodynamic genes to predict the metabolism, safety, or therapeutic efficacy of psychotropic medications commonly used for the treatment of depression, schizophrenia, and bipolar illness.



Read More: http://informahealthcare.com/doi/abs/10.3109/09540261.2013.825579

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