[Pharmacogenetics and tailored drug treatment in schizophrenia].
BACKGROUND
Medical treatment of psychiatric disorders is often characterised by trial and error. Psychotropic drugs show a large variation in response and side effects. Molecular genetic techniques seem to have a potential for identifying biological predictors of drug response and side effects, and help to establish tailored drug treatment.


METHODS
Based on relevant literature and own research, this article gives a short overview of some pharmacogenetic aspects related to pharmacological treatment of schizophrenia.


RESULTS
Antipsychotic and antidepressive drugs are metabolized by many different enzymes in the cytochrome P450 system. The rate of the drug-metabolism depends to some extent on genetic variants, and several gene-variants affect the serum level of the drugs, which may cause side effects or non-response. Several pharmacogenetic studies have indicated that both the therapeutic response and the level of motor and metabolic side effects of antipsychotic drug treatment of schizophrenia are related to polymorphisms in the serotonine and dopamine receptor genes, but there are conflicting findings.


CONCLUSIONS
However, most of these data remain preliminary, and so far pharmacogenetics has been of little practical help for clinical psychiatry. Due to the progress in molecular genetics and improved quality of clinical studies, there is a hope that a new generation of psychiatric pharmacogenetic studies will provide us with more useful information for drug treatment of schizophrenia and other psychiatric conditions.
Andreassen
Ole A
OA
Institutt for psykiatri, Universitetet i Oslo. o.a.andreassen@medisin.uio.no
Steen
Vidar M
VM
D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D005838:Genotype; D006801:Humans; D010597:Pharmacogenetics / Q000639:trends; D011110:Polymorphism, Genetic; D011954:Receptors, Dopamine / Q000235:genetics; D011985:Receptors, Serotonin / Q000235:genetics; D012559:Schizophrenia / Q000188:drug therapy*
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011954:Receptors, Dopamine; D011985:Receptors, Serotonin; D003577:Cytochrome P-450 Enzyme System