title: Pharmacogenetic tests for antipsychotic medications: clinical implications and considerations.
abstract: Optimizing antipsychotic pharmacotherapy is often challenging due to significant variability in effectiveness and tolerability. Genetic factors influencing pharmacokinetics and pharmacodynamics may contribute to some of this variability. Research studies have characterized these pharmacogenetic relationships, and some genetic markers are now available as clinical tests. These advances in pharmacogenetics research and test availability have great potential to improve clinical outcomes and quality of life in psychiatric patients. For clinicians considering using pharmacogenetics, it is important to understand the clinical implications and also the limitations of markers included in currently available tests. This review focuses on pharmacokinetic and pharmacodynamic gene variants that are currently available in commercial genetic testing panels. Associations of these variants with clinical efficacy and adverse effects, as well as other clinical implications, in antipsychotic pharmacotherapy are discussed.
authors.affiliation: College of Pharmacy, Department of Experimental and Clinical Pharmacology; University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Seenae
authors.initials: S
authors.lastname: Eum
authors.affiliation: College of Pharmacy, Department of Experimental and Clinical Pharmacology; University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Department of Experimental and Clinical Pharmacology; College of Medicine, Department of Psychiatry; University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Bishop
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics; D014150:Antipsychotic Agents / Q000378:metabolism / Q000493:pharmacokinetics / Q000494:pharmacology*; D002394:Catechol O-Methyltransferase / Q000235:genetics; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D005819:Genetic Markers; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism; D000071185:Pharmacogenomic Testing; D017448:Receptors, Dopamine D2 / Q000235:genetics; D044348:Receptors, Serotonin, 5-HT2 / Q000235:genetics
chemical_list: C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D014150:Antipsychotic Agents; D005819:Genetic Markers; D017448:Receptors, Dopamine D2; D044348:Receptors, Serotonin, 5-HT2; D003577:Cytochrome P-450 Enzyme System; C588010:COMT protein, human; D002394:Catechol O-Methyltransferase
keywords: antipsychotics; pharmacodynamics; pharmacogenetics; pharmacokinetics; polymorphism; pychosis