title: Pharmacogenetics informed decision making in adolescent psychiatric treatment: a clinical case report.
abstract: Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA. tsmith2@kumc.edu.
authors.forename: Teri
authors.initials: T
authors.lastname: Smith
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA. ssharp@kumc.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Sharp
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA. amanzardo@kumc.edu.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Manzardo
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA. mbutler4@kumc.edu.
authors.forename: Merlin G
authors.initials: MG
authors.lastname: Butler
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000235:genetics*; D002648:Child; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics* / Q000378:metabolism; D003657:Decision Making; D006801:Humans; D008297:Male; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide; D011619:Psychotropic Drugs / Q000378:metabolism / Q000627:therapeutic use*; D013379:Substrate Specificity
chemical_list: D011619:Psychotropic Drugs; D003577:Cytochrome P-450 Enzyme System; D019389:Cytochrome P-450 CYP2D6