Clin Psychopharmacol Neurosci.  2018 Aug;16(3):349-357. 10.9758/cpn.2018.16.3.349.

Usefulness of Pharmacogenetic Analysis in Psychiatric Clinical Practice: A Case Report

Affiliations
  • 1Department of Psychiatry and Mental Health, Zamora Hospital, Zamora, Spain. mfm@intras.es
  • 2Biosciences Institute of Salamanca, University of Salamanca, Salamanca, Spain.
  • 3Department of Medicine, University of Salamanca, Salamanca, Spain.
  • 4Department of Clinical Biochemistry, University Hospital of Salamanca, Salamanca, Spain.

Abstract

There are many factors involved in the effectiveness and efficiency of psychiatric drug treatment. One of them is psychotropic drug metabolism, which takes place mostly in the liver through the P450 enzyme system. However, there are genotypic variants of this system’s enzymes that can directly affect both the efficacy and the onset of side effects of a given therapeutic regimen. These genotypic changes could partly explain the lack of efficacy of treatment in certain patients. We report the case of a patient diagnosed with bipolar type I disorder that presented multiple and frequent manic episodes in which the efficacy and tolerability of several pharmacological regimens with mood stabilizers and antipsychotics was scarce. The choice of medical treatment should be based on its efficacy and side effect profile. This decision can be made more accurately using the information provided by pharmacogenetic analysis. This case illustrates the importance of pharmacogenetic studies in clinical practice. The results of pharmacogenetic analysis helped to decide on a better treatment plan to achieve clinical improvement and reduce drug-induced adverse effects.

Keyword

Bipolar disorder; Antipsychotic drugs; Pharmacogenetics; Cytochrome P450; Individualized medicine
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