Pharmacogenomics in Psychiatry

Description

In recent years, there have been major developments in the fields of pharmacogenetics and pharmacogenomics, with the potential to make drug treatments in psychiatric medicine more effective. However, improvements in drug efficacy and tolerability, as well as finding the optimal dosage, can only be realized if in vivo mechanisms of drug action and ADME (absorption, distribution, metabolism, excretion) processes (pharmacokinetics) of psychopharmacological agents are better understood. In this volume, current progress and perspectives in pharmacogenetic testing of drug-metabolizing enzymes, drug transporters and other drug targets involved in the response to psychotropic agents are described extensively. This provides a timely overview of what has been achieved in the area of psychiatric pharmacogenomics alongside some promising directions and perspectives for future research.Psychiatrists, general medical doctors as well as pharmacologists and clinical pharmacologists will find new insights into the development and applications of pharmacogenomics in psychiatry.

Informations

• Publié par: S. Karger AG
• Date de parution: 25 juin 2010
• Nombre de lectures: 0
• EAN13: 9783805594998
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Pharmacogenomics in Psychiatry
Advances in Biological Psychiatry
Vol. 25
Series Editors
D. Ebert     Freiburg
K.P. Ebmeier     Oxford
W.F. Gattaz1     São Paulo
W.P. Kaschka     Ulm/Ravensburg
 
Pharmacogenomics in Psychiatry
Volume Editors
M. Schwab    Stuttgart/Tübingen
W.P. Kaschka     Ulm/Ravensburg
E. Spina     Messina
8 figures, 4 in color, and 17 tables, 2010
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Prof. Dr. Matthias Schwab Dr. Margarethe Fischer-Bosch Institute of Clinical Pharmacology Auerbachstrasse 112 DE-70376 Stuttgart (Germany) and Department of Clinical Pharmacology Institute of Experimental and Clinical Pharmacology and Toxicology, University Hospital, Tübingen, Germany
Prof. Dr. Wolfgang P. Kaschka Department of Psychiatry I University of Ulm ZfP Südwürttemberg Weingartshofer Strasse 2 DE-88214 Ravensburg (Germany)
Prof. Dr. Edoardo Spina Department of Clinical and Experimental Medicine and Pharmacology Section of Pharmacology University of Messina Policlinico Universitario Via Consolare Valeria IT-98125 Messina (Italy)
Library of Congress Cataloging-in-Publication Data
Pharmacogenomics in psychiatry / volume editors, M. Schwab, W.P. Kaschka, E. Spina.
p. ; cm.- (Advances in biological psychiatry, ISSN 0378-7354 ; v. 25)
Includes bibliographical references and indexes.
ISBN 978-3-8055-9498-1 (hard cover: alk. paper)- ISBN 978-3-8055-9499-8 (e-ISBN)
1. Mental illness—Chemotherapy. 2. Mental illness-Genetic aspects. 3. Pharmacogenomics. I. Schwab, M. (Matthias) II. Kaschka, Wolfgang P. III. Spina, E. (Edoardo) IV. Series: Advances in biological psychiatry, v. 25. 0378-7354;
[DNLM: 1. Mental Disorders—drug therapy. 2. Mental Disorders-genetics. 3. Pharmacogenetics—methods. 4. Psychotropic Drugs—pharmacokinetics. W1 AD44 v.25 2010 / WM 402 P5345 2010]
RC483.P4916 2010
616.89'061-dc22
2010017163
Bibliographic Indices. This publication is listed in bibliographic services, including Pub Med/MEDLINE.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2010 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 0378-7354
ISBN 978-3-8055-9498-1
e-ISBN 978-3-8055-9499-8
 
Contents
Preface
One Tablet or Two? Towards the Development of Pharmacogenomically Informed Drug Dose Individualization
Kirchheiner, J.; Seeringer, A.; Viviani, R.; Hodgkinson, S. (Ulm)
Pharmacogenomics: Reflecting on the Old and New Social, Ethical and Policy Issues in Postgenomics Medicine
Ozdemir, V. (Montreal, Que.)
Pharmacogenomics and Personality: Role of CYP2D6 and Implications for Psychopathology
Peñas-LLedó, E.M.; Dorado, P.; LLerena, A. (Badajoz)
Pharmacogenetics of Schizophrenia: Bringing 'Order to Chaos' in the Psychopharmacology of Schizophrenia?
Buckley, P.F.; Miller, D.D.; Foster, A. (Augusta, Ga.)
Pharmacogenomics of Depression
Serretti, A.; Drago, A. (Bologna); Spina, E. (Messina)
Pharmacogenomics of Attention-Deficit/Hyperactivity Disorder
Froehlich, T. (Cincinnati, Ohio); Stein, M.A. (Chicago, III.)
Pharmacogenomics of Eating Disorders
Monteleone, P.; Maj, M. (Naples)
Future of Personalized Prescription in Psychiatry
de Leon, J. (Lexington, Ky./Granada)
Author Index
Subject Index
 
Preface
Psychiatrists have followed developments in the rapidly expanding field of pharma-cogenetics and pharmacogenomics with great interest. Methods for making drug treatment more effective have been the central focus in psychiatric medicine in recent years (‘the right drug for the right patient’). However, improvements in drug efficacy and tolerability and finding of the optimal dosage can only be realized if in vivo mechanisms of drug action (pharmacodynamics) and ADME (absorption, distribution, metabolism, excretion) processes (pharmacokinetics) of psychopharmacological agents are better understood. The urgent need for further progress in this field is obvious.
A number of comprehensive multicenter studies have shown that, in terms of efficacy and tolerability, the pharmacological treatment strategies presently available for common psychiatric diseases are still far from satisfactory. For example, in the first level of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, only about 30% of patients were in remission after follow-up of 12 weeks’ drug therapy using a selective serotonin reuptake inhibitor [ 1 ]. There is also a substantial body of evidence available indicating that even amongst antidepressant responders residual symptoms are common and associated with poorer psychosocial functioning as well as increased relapse rates [ 2 ]. As far as schizophrenia is concerned, pharmacological treatments which block the dopamine system are usually effective for delusions and hallucinations, but less so for disabling cognitive and motivational impairments [ 3 , 4 ]. The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study showed, among other things, that non-compliance to prescribed medication is a major clinical problem in antipsychotic therapy. For instance, Lieberman et al. [ 5 ] reported that the majority of patients in each of several study groups receiving different antipsychotics discontinued their assigned treatment owing to inefficacy or intolerable side effects or for other reasons.
In this volume of Advances in Biological Psychiatry, current progress and perspectives in pharmacogenetic testing of drug-metabolizing enzymes, drug transporters and other drug targets involved in the response to psychotropic agents are described extensively. There are great expectations that in the near future pharmacogenomics will provide us with the means of identifying subgroups of patients which are at risk of therapeutic failure or more vulnerable to certain adverse effects of psychopharma-cological agents. To mention just two examples from recent years: an association has been detected between treatment-emergent suicidal ideation in individuals receiving citalopram therapy and polymorphisms near the cyclic adenosine monophosphate response element binding protein (CREB-1) gene [ 6 ]. In another example, data from a study conducted by Opgen-Rhein and Dettling [ 7 ] suggest that certain groups of patients carry a genetically determined proneness to clozapine-induced agranulocytosis (as described in this volume by Buckley et al.). Of course, these findings have to be replicated and further research will be necessary in these areas.
Although polymorphisms of genes are useful markers to explain interindividual variability in ADME processes and drug response, the early enthusiasm about the promise of individualized therapy in psychiatric diseases and personalized medicine in general has been tempered by the complexity and multifactorial character of drug responses [ 8 ]. Impressive developments in a number of genomic profiling approaches- such as microarray technologies, genome-wide association studies and most recently the next-generation sequencing technique- have given rise to the hope that more comprehensive information about a patient's genomic profile will be available in the near future for improvements in patient care in psychiatric medicine. More-over, epigenetic mechanisms (i.e. DNA methylation, histone modification and regulation by miRNA), which may result in individual modification of gene expression and phenotype without affecting the DNA sequence, need to be considered as important players in the complex interactions between the multiple genes and environmental factors shaping a distinct phenotype.
This volume presents a timely overview of what has been achieved up to now in the field of psychiatric pharmacogenomics and some promising directions and perspectives for future research that could ultimately lead to substantial improvements in treatment.
We gratefully acknowledge the cont