title: Physiogenomic comparison of weight profiles of olanzapine- and risperidone-treated patients.
abstract: Atypical antipsychotics induce pre-diabetic symptoms in some but not all patients, characterized most notably by elevated weight. The side effect profiles of the various drugs in the class differ, however, raising the possibility of drug-specific mechanisms for similar side effects. We used physiogenomic analysis, an approach previously employed to study the genetics of drug and diet response, to discover and compare genetic associations with weight profiles observed in patients treated with olanzapine and risperidone as an approach to unraveling contrasting mechanistic features of both drugs. A total of 29 single nucleotide polymorphisms (SNPs) were selected from 13 candidate genes relevant to two potential pharmacological axes of psychotropic-related weight profiles, appetite peptides and peripheral lipid homeostasis. We applied physiogenomic analysis to a cross-section of 67 and 101 patients being treated with olanzapine and risperidone, respectively, and assessed genetic associations with the weight profiles. Weight profiles in patients treated with olanzapine were significantly associated with SNPs in the genes for apolipoprotein E, apolipoprotein A4 and scavenger receptor class B, member 1. Weight profiles in patients treated with risperidone were significantly associated with SNPs in the genes for leptin receptor, neuropeptide Y receptor Y5 and paraoxonase 1. These results are consistent with contrasting mechanisms for the weight profile of patients treated with these drugs. Genes associated with olanzapine weight profiles may be related to peripheral lipid homeostatic axes, whereas those associated with risperidone's may be related to brain appetite peptide regulation. Future physiogenomic studies will include neurotransmitter receptor SNPs and validation in independent samples.
authors.affiliation: Genomas, Inc., Hartford, CT, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ruaño
authors.forename: J W
authors.initials: JW
authors.lastname: Goethe
authors.forename: C
authors.initials: C
authors.lastname: Caley
authors.forename: S
authors.initials: S
authors.lastname: Woolley
authors.forename: T R
authors.initials: TR
authors.lastname: Holford
authors.forename: M
authors.initials: M
authors.lastname: Kocherla
authors.forename: A
authors.initials: A
authors.lastname: Windemuth
authors.forename: J
authors.initials: J
authors.lastname: de Leon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001053:Apolipoproteins / Q000187:drug effects / Q000235:genetics; D001069:Appetite Regulation / Q000187:drug effects / Q000235:genetics*; D043303:Aryldialkylphosphatase / Q000187:drug effects / Q000235:genetics; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D023281:Genomics / Q000379:methods; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects / Q000235:genetics*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D000077152:Olanzapine; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011956:Receptors, Cell Surface / Q000187:drug effects / Q000235:genetics; D054411:Receptors, Leptin; D017476:Receptors, Neuropeptide Y / Q000187:drug effects / Q000235:genetics; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D051122:Scavenger Receptors, Class B / Q000187:drug effects / Q000235:genetics; D015430:Weight Gain / Q000187:drug effects / Q000235:genetics*
chemical_list: D014150:Antipsychotic Agents; D001053:Apolipoproteins; D011956:Receptors, Cell Surface; D054411:Receptors, Leptin; D017476:Receptors, Neuropeptide Y; C495124:SCARB1 protein, human; D051122:Scavenger Receptors, Class B; C100568:neuropeptide Y5 receptor; D001569:Benzodiazepines; D043303:Aryldialkylphosphatase; D018967:Risperidone; D000077152:Olanzapine