Pharmacogenetic Research Evaluation in Psychiatry: a Retrospective Analysis of Clinical Cases

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Mon, 2016/05/23 - 20:43
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Laboratorinė medicina. 2016,
t. 18,
Nr. 1,
p. 23 -
28

Background. Personalized medicine, targeted to a particul ar patient, is get­ting increased recognition. Genetic test­ing is successfully applied in oncology, haematology and other fields of medi­cine. However, clinical application in psychiatry is still awaited. In the spot­light is genetic polymorphism of CYP450 family enzymes that are responsible for a substantial part of psychotropic drugs metabolism. In this ar ti cle we are seeking to evaluate the utility of pharmacogenetic testing of genes that code these enzymes. For this reason, we will retrospectively analyze the pharma­cological treatment course of patients that were diagnosed with affective disor­ders.

Material and methods. Five patients that were treated for affective disorders in Vilnius University hospital Santariskiu Clinics Centre of Neurology Psychiatry De­partment were selected for genetic testing. Blood samples were taken. Genetic material that was extracted from them was ana­lyzed with Autogenomics Infiniti sysfem. According to patients CYP2C19, CYP2D6 and CYP2C9 enzymes genetic polymor­phism it generated automatic report with treatment recommendations. Results were compared with the course of previous phar­macological treatment.

Results. Four out of five patients had CYP2C19 genetic polymorphism. In all of these cases 1*/2* variant, that condi­tions intermediate metabolizer pheno­type, was identified. After the retrospec­tive evaluation of the pharmacological treatment courses, we found that in three cases the presence of this genetic variant could have been clinically relevant. Alter­ations in CYP2C9 and CYP2D6 enzymes alleles were not found.

Conclusions. Pharmacogenetic test­ing could have had influence on treat­ment choices for three out of five pa­tients. More extensive studies on pharmacogenetic test ing that would in­clude comparison between objective clini­cal effectivity of treatment, measured drug concentration in serum and genetic testing results are needed

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