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