title: Genetics of psychotropic medication induced side effects in two independent samples of bipolar patients.
abstract: The treatment of bipolar disorder (BD) usually requires combination therapies, with the critical issue of the emergence of adverse drug reactions (ADRs) and the possibility of low treatment adherence. Genetic polymorphisms are hypothesized to modulate the pharmacodynamics of psychotropic drugs, representing potential biological markers of ADRs. This study investigated genes involved in the regulation of neuroplasticity (BDNF, ST8SIA2), second messenger cascades (GSK3B, MAPK1, and CREB1), circadian rhythms (RORA), transcription (SP4, ZNF804A), and monoaminergic system (HTR2A and COMT) in the risk of neurological, psychic, autonomic, and other ADRs. Two independent samples of BD patients naturalistically treated were included (COPE-BD n = 147; STEP-BD n = 659). In the COPE-BD 34 SNPs were genotyped, while in the STEP-BD polymorphisms in the selected genes were extracted from the genome-wide dataset. Each ADRs group was categorized as absent-mild or moderate-severe and logistic regression with appropriate covariates was applied to identify possible risk genotypes/alleles. 58.5 and 93.5 % of patients were treated with mood stabilizers, 44.2 and 50.7 % were treated with antipsychotics, and 69.4 and 46.1 % were treated with antidepressants in the COPE-BD and STEP-BD, respectively. Our findings suggested that ST8SIA2 may be associated with psychic ADRs, as shown in the COPE-BD (rs4777989 p = 0.0017) and STEP-BD (rs56027313, rs13379489 and rs10852173). A cluster of RORA SNPs around rs2083074 showed an effect on psychic ADRs in the STEP-BD. Trends supporting the association between HTR2A and autonomic ADRs were found in both samples. Confirmations are needed particularly for ST8SIA2 and RORA since the few available data regarding their role in relation to psychotropic ADRs.
authors.affiliation: Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123, Bologna, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fabbri
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calati
authors.forename: Concetta
authors.initials: C
authors.lastname: Crisafulli
authors.forename: Armando
authors.initials: A
authors.lastname: Chierchia
authors.forename: Diego
authors.initials: D
authors.lastname: Albani
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Forloni
authors.forename: Alberto
authors.initials: A
authors.lastname: Chiesa
authors.forename: Rosalba
authors.initials: R
authors.lastname: Martines
authors.forename: Othman
authors.initials: O
authors.lastname: Sentissi
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Girolamo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000235:genetics*; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics; D002394:Catechol O-Methyltransferase / Q000235:genetics; D064420:Drug-Related Side Effects and Adverse Reactions / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D005838:Genotype; D038362:Glycogen Synthase Kinase 3 / Q000235:genetics; D000071679:Glycogen Synthase Kinase 3 beta; D006801:Humans; D008297:Male; D008875:Middle Aged; D057094:Nuclear Receptor Subfamily 1, Group F, Member 1 / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011619:Psychotropic Drugs / Q000009:adverse effects*; D044402:Receptor, Serotonin, 5-HT2A; D015398:Signal Transduction / Q000187:drug effects / Q000235:genetics; D051706:Sp4 Transcription Factor / Q000235:genetics
chemical_list: D019208:Brain-Derived Neurotrophic Factor; D057094:Nuclear Receptor Subfamily 1, Group F, Member 1; D011619:Psychotropic Drugs; C539738:RORA protein, human; D044402:Receptor, Serotonin, 5-HT2A; C497124:SP4 protein, human; D051706:Sp4 Transcription Factor; C588010:COMT protein, human; D002394:Catechol O-Methyltransferase; C000605506:GSK3B protein, human; D000071679:Glycogen Synthase Kinase 3 beta; D038362:Glycogen Synthase Kinase 3