title: Psychiatry meets pharmacogenetics for the treatment of revolving door patients with psychiatric disorders.
abstract: Therapeutic failures (TFs) and adverse drug reactions (ADRs), together with the recurring nature of the clinical course of psychiatric disorders, mainly bipolar disorders (BDs), strongly contributed to the prevalence and frequency of hospital readmissions observed in these patients. This is the revolving door (RD) condition, dramatically rising costs for the management of these patients in psychiatric settings. Areas covered: We searched in the medical literature until May 2016 to review the role of functional variants in the cytochrome P450 (CYP) 2D6 gene on observed ADRs and TFs in RD patients with BDs, conferring a different capacity to metabolize psychotropic drugs. Expert commentary: CYP2D6 functional polymorphisms might directly contributed to the prevalence and frequency of the RD condition, commonly observed in BD patients. Although several environmental and socio-demographic/diagnostic variables such as alcohol/drug abuse, and medication non-compliance accounted for a significant proportion of the ability to predict RD prevalence and frequency, the pharmacogenetics of CYP, particularly CYP2D6, may help to identify BD patients at risk for ADRs and TFs. These patients may be addressed towards alternative treatments, thus improving their quality of life, and reducing RD prevalence and frequency and the overall costs for their management.
authors.affiliation: a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.|b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.|c Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology , University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico" , Lecce , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
authors.affiliation: b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.|d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy.
authors.forename: Madia
authors.initials: M
authors.lastname: Lozupone
authors.affiliation: d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Stella
authors.affiliation: e Psychiatric Unit, Department of Basic Medicine Sciences, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lofano
authors.affiliation: a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Gravina
authors.affiliation: a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Urbano
authors.affiliation: f Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Daniele
authors.affiliation: d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Bellomo
authors.affiliation: b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.|c Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology , University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico" , Lecce , Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.affiliation: a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Greco
authors.affiliation: a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Seripa
mesh_terms: D006801:Humans; D055118:Medication Adherence; D001523:Mental Disorders / Q000188:drug therapy; D010597:Pharmacogenetics; D011570:Psychiatry; D011788:Quality of Life
keywords: CYP2D6; Therapeutic failures; adverse drug reactions; pharmacogenetics; psychiatric disorders; revolving door patients