Pharmacogenetics of antipsychotics: useful for the clinician?
OBJECTIVE
The concept of individualized drug therapy on the basis of pharmacogenetics has become a central focus in psychopharmacology of schizophrenia. This article reviews recent advances in this field with respect to their importance for the clinician.


RESULTS
First, there is an increasing agreement about the importance of polymorphisms in cytochrome P450 enzymes and the effects of drug-drug interactions in relation to the incidence of adverse effects. Secondly, prediction of response on the basis of variants in candidate genes is incipient and remains elusive. Thirdly, some advances have been made in understanding the pharmacogenetics of weight gain.


CONCLUSIONS
Despite much effort, only a few of the results are now ready for translation into clinical practice. Cytochrome P450 genotyping would be a big step forward towards a more individualized drug treatment based on molecular diagnostics and could improve treatment, reduce adverse effects and increase compliance of the patients. Another promising field may be that of predicting the antipsychotic-induced weight gain and it is hoped that commercially available DNA tests may be available within the next few years. Prediction of response is still hampered by many methodological and clinical problems and is not yet available to the clinician.
Bondy
Brigitta
B
Psychiatric Clinic of LMU Munich, Germany. brigitta.bondy@med.uni-muenchen.de
Spellmann
Ilja
I
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D004347:Drug Interactions; D005820:Genetic Testing; D014644:Genetic Variation; D006801:Humans; D010597:Pharmacogenetics; D012559:Schizophrenia / Q000188:drug therapy* / Q000235:genetics*; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003577:Cytochrome P-450 Enzyme System