Skip to main content
×
×
Home

Service innovations: Pharmacogenetic clinics in psychiatry: a clinical reality?

  • Richard Hodgson (a1), Susan E. Smith (a2), Richard C. Strange (a2) and Anthony A. Fryer (a3)
Abstract
Aims and Method

There are few descriptions in the literature of pharmacogenetic applications in psychiatry. We describe the relevance of pharmacogenetics to clinical psychiatry using a case-note review of the first 55 patients to have their cytochrome P450 (CYP2D6) status assessed in a general psychiatry clinic.

Results

The distribution of genotypes for CYP2D6 was the same as in the general population. A smaller number of reported side-effects (P=0.01) and higher medication dosages (P=0.001) were significantly associated with the extensive metabolism genotype.

Clinical Implications

This preliminary study suggests that CYP2D6 status may have an influence on medication dosage and adverse drug events reported by patients. Recommendations for further development are suggested.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Service innovations
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Service innovations
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Service innovations
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
Hide All
Arranz, M. J., Collier, D., Sodhi, M., et al (1995) Association between clozapine response and allelic variation in 5-HT2A receptor gene. Lancet, 346, 281282.
Arranz, M. J., Munro, J., Sham, P., et al (1998) Meta analysis of studies on variation in 5-HT2A receptors and clozapine response. Schizophrenia Research, 32, 9399.
Chou, W. H., Yan, F. X., de Leon, J., et al (2000) Extension of a pilot study: impact from the P450 2D6 polymorphism on outcome and costs associated with severe mental illness. Journal of Clinical Psychopharmacology, 20, 246251.
Cozza, K. L. & Armstrong, S. C. (2001) The Cytochrome P450 System. Drug Interaction Principles for Medical Practice. Washington, DC: American Psychiatric Publishing.
Elexperu-Camiruaga, J., Buxton, N., Kandula, V., et al (1995) Susceptibility to astrocytoma and meningioma: influence of allelism at glutathione S-transferase, GSTT1 and GSTM1 and cytochrome P450, CYP2D6 loci. Cancer Research, 55, 42374239.
Fakhoury, W. K., Wright, D. & Wallace, M. (2001) Prevalence and extent of distress of adverse effects of antipsychotics among callers to a United Kingdom National Mental Health Helpline. International Clinical Psychopharmacology, 16, 153162.
Griffin, J. P. (1997) The cost of adverse drug reactions. Adverse Drug Re actions and Toxicological Reviews, 16, 7578.
Hellewell, J. S. (2002) Patients' subjective experiences of antipsychotics: clinical relevance. CNS Drugs, 16, 457471.
Lazarou, J., Pomeranz, P. H. & Corey, P. N. (1998) Incidence of adverse drug reactions in hospitalised patients: a meta-analysis of prospective studies. JAMA, 279, 12001205.
Mcleod, H. L., Krynetski, E.Y., Relling, M.V., et al (2000) Genetic polymorphism of thiopurine methyltransferase and its clinical relevance for childhood acute lymphoblastic leukemia. Leukaemia, 14, 567572.
Meyer, U. A., Amrein, R., Balant, L. P., et al (1996) Antidepressants and drug-metabolizing enzyme – expert group report. Acta Psychiatrica Scandinavica, 93, 7179.
Perry, P. J. (2000) Therapeutic drug monitoring of atypical antipsychotics. Is it of potential clinical value? CNS Drugs, 13, 167171.
Richelson, E. (1997) Pharmacokinetic drug interactions of the new antidepressants: a review of the effects on the metabolism of other drugs. Mayo Clinic Proceedings, 72, 835847.
van Aken, J., Schmedders, M., Feuerstein, G., et al (2003) Prospects and limits of pharmacogenetics. The thiopurine methyltransferase (TPMT) experience. American Journal of Pharmacogenomics, 3, 147155.
Wolf, C. R., Smith, G. S. & Smith, R. L. (2000) Pharmacogenetics. BMJ, 320, 987990.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 3 *
Loading metrics...

Abstract views

Total abstract views: 58 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 15th July 2018. This data will be updated every 24 hours.

Service innovations: Pharmacogenetic clinics in psychiatry: a clinical reality?

  • Richard Hodgson (a1), Susan E. Smith (a2), Richard C. Strange (a2) and Anthony A. Fryer (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *