The Implications of Cytochrome P450 2D6/CYP2D6 Polymorphism in the Therapeutic Response of Atypical Antipsychotics in Adolescents with Psychosis—A Prospective Study
Adriana Cojocaru,
Adina Braha,
Roxana Jeleriu,
Nicoleta Ioana Andreescu,
Maria Puiu,
Luminita Ageu,
Roxana Folescu,
Carmen Lacramioara Zamfir,
Laura Alexandra Nussbaum
Affiliations
Adriana Cojocaru
Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Adina Braha
Department of Second Internal Medicine-Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Roxana Jeleriu
Department of Microscopic Morphology, Discipline of Genetics, Genomic Medicine Centre, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Nicoleta Ioana Andreescu
Department of Microscopic Morphology, Discipline of Genetics, Genomic Medicine Centre, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Maria Puiu
Department of Microscopic Morphology, Discipline of Genetics, Genomic Medicine Centre, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Luminita Ageu
Mental Health Department for Children and Adolescents, “Louis Turcanu” Children’s Emergency Hospital, 2 Doctor Iosif Nemoianu, 300011 Timisoara, Romania
Roxana Folescu
Department of Balneology, Medical Recovery and Rheumatology, Family Medicine Discipline, Center for Preventive Medicine, Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Carmen Lacramioara Zamfir
Department of Morpho-Functional Sciences I, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
Laura Alexandra Nussbaum
Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
Background: The plasma level of antipsychotics and their metabolites depends on the activity of the cytochrome P450 (CYP) system in the liver. This research aims to test the individual response variability to atypical antipsychotic drugs, depending on the activity of the CYP2D6 enzyme. Methods: In a prospective, noninterventional study, we included 56 adolescents, 51.79% male, diagnosed with schizophrenia. The patients underwent DNA sampling for genotyping SNP by RT-PCR and CYP* allelic variants using Applied Bio-systems™ TaqMan® Assays Foster City, CA, USA). and clinical and paraclinical assessments. The effectiveness of the therapy was evaluated with the PANSS scores at baseline and 3, 6, and 12 months after the initiation of an atypical antipsychotic treatment. Results: Based on the genotyping results, the patients were divided into slow metabolizers (Group 1), extensive metabolizers (Group 2), and intermediate metabolizers (Group 3). The PANSS score showed a significant decrease in Group 2, compared to Group 3 after 3 (p = 0.02), 6 (p = 0.0009), and 12 months (p < 0.0001). The patients in Group 1 showed high PANSS scores, and those in Group 2 had fewer adverse reactions than the other groups. Conclusions: Assessing the CYP2D6 polymorphism may be useful in clinical pediatric psychiatric practice towards improving clinical results and patients’ quality of life.
