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Analysis of genetic polymorphisms, adverse drug reactions and targeted treatment

Published online by Cambridge University Press:  23 March 2020

E. Stella ,
M. La Montagna ,
D. Seripa ,
M. Giuseppe ,
L. di Mauro ,
A. Greco ,
A. Rinaldi ,
M.S. Martone ,
A. Bellomo  and
M. Lozupone
E. Stella*
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy
M. La Montagna
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy
D. Seripa
Affiliation:
IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, San Giovanni Rotondo, Italy
M. Giuseppe
Affiliation:
IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, San Giovanni Rotondo, Italy
L. di Mauro
Affiliation:
IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, San Giovanni Rotondo, Italy
A. Greco
Affiliation:
IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, San Giovanni Rotondo, Italy
A. Rinaldi
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy
M.S. Martone
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy
A. Bellomo
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy
M. Lozupone
Affiliation:
University of Foggia, Department of Mental Health, Psychiatric Unit, Asl Fg, Foggia, Italy University of Bari “A. Moro”, Department of Basic Medical Sciences, Neurosciences and Sense Organs, Bari, Italy
*
*Corresponding author.

Abstract

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Introduction

Bipolar disorders (BD) are chronic and recurrent psychopathological conditions characterized by therapeutic failures (TFs), regardless of the initial choice of psychiatric medication with a high prevalence of adverse drug reactions (ADRs). Cytochrome P450(CYP)2D6 genetics has been recently suggested to have a role in the response to treatment and extra-pyramidal symptoms (EPS) across several psychiatric conditions.

Objectives

To evaluate interindividual differences in CYP2D6 enzyme activities, TFs and ADRs rates in BDs patients.

Aims

To tailor psychiatric medication choice and dose based on pharmacogenetic test.

Methods

We analyzed 16 clinical relevant polymorphisms CYP2D6 genotype in Psychiatric Unit of Foggia using the InfinitiTM Analyzer; the Simpson Angus Scale (SAS) was used to measure drug-induced EPS and Brief Psychiatric Rating Scale-24 (BPRS-24) response to treatment.

Results

Ten drug-resistant patients were consecutively enrolled, and six of these experience major ADR during therapy with worsening of symptoms before screening for CYP polymorphism: BM (*2A/*5 genotype, BPRS-24 T0: 63, T14: 51), SR (*2A/*4, BPRS-24 T0: 66, T14: 59), LT (*4/*17 BPRS-24 T0: 72, T14: 64), DC (*2A/*4A BPRS-24 T0: 69, T14: 54), AL (*2A/*2A, BPRS-24 T0: 72, T14: 64), PA (*2A/*2A BPRS-24 T0: 52, T14: 46).

Conclusions

According to the specific CYP2D6 polymorphism, we personalized patients’ treatment considering that poor and extensive metabolizers have different rates of ADR and responses to treatment. CYP2D6 genotype's knowledge is useful for the reduction of therapeutic attempt during patient clinical history, thus reducing admission time and costs, and to guide clinicians toward a better patient management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
FC11
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S75 - S76
Copyright
Copyright © European Psychiatric Association 2016
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