在患有精神病的患者中,CYP2D6转换的临床影响
Emma Y De Brabander1, Esmee Breddels2, Therese van Amelsvoort1
1Department of Psychiatry and Neuropsychology, Research Institute for Mental Health and Neuroscience, Maastricht University (Medical Center), Maastricht, The Netherlands.
Journal of psychopharmacology (Oxford, England)
|September 23, 2024
概括
药物遗传学在精神疾病方面显示了不同的结果. 受药物相互作用影响的转化显著增加了不良代谢器,但没有强烈预测大多数药物的治疗结果,除了RISPERIDONE.
科学领域:
- 药物遗传学 药物遗传学
- 精神病学药理学 精神病学药理学
- 药物新陈代谢 药物新陈代谢
背景情况:
- 药物遗传学有望提高治疗结果,但其在精神疾病中的临床实用性仍在争论中.
- 多药在精神病治疗中很常见,导致药物相互作用,改变细胞染色体P450 (CYP) 酶活性,这一过程被称为转化.
- 现象转换可能会混对精神病药物的临床研究结果的解释.
研究的目的:
- 研究在接受药物治疗的精神疾病患者中CYP2D6转换的影响和预测价值.
- 评估转化如何影响药物代谢表型及其与临床结果的关联.
主要方法:
- 通过考虑同时服用药物的抑制强度来计算变校正的表型.
- 基因型预测和基因转换校正的表型与副作用,主观幸福感和症状严重程度的指标进行了比较.
- 该研究的重点是CYP2D6酶活性及其在药物代谢中的作用.
主要成果:
- 转化显著增加了差代谢剂 (PMs) 的比例,特别是由于和帕洛的联合使用.
- 既没有CYP2D6基因型预测的,也没有经过转换校正的表型与一般结果指标显示出强有力的关联.
- 里斯佩里治疗结果受到患者CYP2D6基因型的显著影响.
结论:
- 在精神病患者中,多药和现象转换是常见的,大大增加了PMs的患病率.
- CYP2D6基因型在预测该群体的副作用,症状和幸福感方面似乎发挥着有限的作用.
- 鉴于其高患病率,应在未来涉及精神病患者的临床试验中考虑表转化.
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