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Homozygous mutation at cytochrome P4502D6 in an individual with schizophrenia: Implications for antipsychotic drugs, side effects and compliance

Published online by Cambridge University Press:  13 June 2014

Marcus Webb
Affiliation:
Departments of Psychiatry and Genetics, Trinity Centre for Health Sciences, St James's Hospital, James's Street, Dublin 8, Ireland

Abstract

We report the case of a patient with schizophrenia who has suffered severe side effects with many different antipsychotics. She is poorly compliant with treatment probably because of her experiences with medication. We determined her genotype at the CYP2D6 gene that codes for an enzyme principally involved in the metabolism of many antipsychotics. She was homozygous for the ‘B’ mutation, the most frequent of several known mutations. She therefore has no functioning CYP2D6 enzyme in common with 5%-10% of the population. This may explain why she is sensitive to quite moderate doses of antipsychotic medication, and more rational prescribing may lead to fewer side effects and increased compliance.

Type
Case Reports
Copyright
Copyright © Cambridge University Press 1997

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References

1.Cholerton, S, Daly, A, Idle, R. The role of individual human cytochrome P450 in drug metabolism and clinical response. TiPS 1992; 13: 434–9.Google ScholarPubMed
2.Gonzalez, F. Human cytochromes P450 problems and prospects. TiPS 1992; 13: 346–52.Google ScholarPubMed
3.Meyer, J, Woggon, B, Baumann, P, Meyer, U. Clinical implications of slow sulphoxidation of thioridazine in a poor metabolizer of the debrisoquine type. Eur J Clin Pharmacol 1990; 39: 613–4.CrossRefGoogle Scholar
4.Daly, AK, Armstrong, M, Monkman, SC, et al.Genetic and metabolic criteria for the assignment of debrisoquine 4-hydroxylation (cytochrome P4502D6) phenotypes. Pharmacogenetics 1991; 1: 3341.CrossRefGoogle ScholarPubMed
5.Dahl-Puustinen, M-L, Liden, A, Aim, C, Nordin, C, Bertilsson, L. Disposition of perphenazine is related to polymorphic debrisoquine hydroxylation in human beings. Clin Pharmacol Ther 1989; 46: 7881.CrossRefGoogle ScholarPubMed