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对抗抑郁药物反应不佳的药物遗传学测试:一个跨诺斯图学案例系列
Marie-Agnès Lorvellec1, Gilles Sipahimalani1, Bertrand Lahutte1,2
1Department of Psychiatry, Bégin National Military Teaching Hospital, Saint-Mandé, France.
Frontiers in pharmacology
|October 24, 2024
概括
药物遗传学 (PGx) 测试在大多数患者中发现了CYP2D6和CYP2C19的遗传变异,指导了抗抑郁药的选择. 这导致药物不良反应和治疗疗效的显著改善,对于那些疗法无效的人来说.
科学领域:
- 精神病学药物基因组学
- 临床遗传学 临床遗传学
- 药物代谢药物代谢
背景情况:
- 药物遗传学 (PGx) 提供了优化心理药物的潜力.
- CYP2D6和CYP2C19是抗抑郁药代谢的关键基因.
- 对抗抑郁药物无效或ADRs的PGx的现实世界数据有限.
研究的目的:
- 评估PGx测试对抗抑郁药物无效或药物不良反应 (ADRs) 的患者的有用性.
- 在这个患者队列中分析CYP2D6和CYP2C19遗传变异的流行率.
- 评估PGx指导处方对治疗结果的影响.
主要方法:
- 一个由40名接受抗抑郁药物问题PGx测试的患者组成的病例系列 (2020年6月至2022年4月).
- 描述患者的人口统计,临床特征和遗传特征.
- 精神科医生的反被用来评估PGx测试的价值.
主要成果:
- 大型抑郁症 (60%) 和PTSD (30%) 是常见的诊断;65%的人经历了无效.
- 只有17.5%的人具有正常的CYP2D6 / CYP2C19活性;在22.0%的基因-抗抑郁药对中发现了可操作的变体.
- 在92.7%的病例中遵循了PGx建议,改善了ADR (71.4%) 和疗效 (79.5%).
结论:
- PGx测试有效指导心理药物处方治疗挑战的患者.
- 药理学上相关的基因变异的高患病率支持在精神病学中更广泛地采用PGx.
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