Pharmacogenetics of schizophrenia in real clinical practice: a clinical case

Schizophrenia is a socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. The basic drugs in these patients are antipsychotics that are highly effective against the positive and negative symptoms of schizophrenia, but at the same time...

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Main Authors: R. F. Nasyrova, N. A. Schnaider, K. O. Mironov, G. A. Shipulin, O. P. Dribnokhodova, E. A. Golosov, M. Yu. Tolmachev, B. V. Andreev, A. A. Kurylev, L. Sh. Akhmetova, О. V. Limankin, N. G. Neznanov
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2018-12-01
Series:Неврология, нейропсихиатрия, психосоматика
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Online Access:https://nnp.ima-press.net/nnp/article/view/1002
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author R. F. Nasyrova
N. A. Schnaider
K. O. Mironov
G. A. Shipulin
O. P. Dribnokhodova
E. A. Golosov
M. Yu. Tolmachev
B. V. Andreev
A. A. Kurylev
L. Sh. Akhmetova
О. V. Limankin
N. G. Neznanov
author_facet R. F. Nasyrova
N. A. Schnaider
K. O. Mironov
G. A. Shipulin
O. P. Dribnokhodova
E. A. Golosov
M. Yu. Tolmachev
B. V. Andreev
A. A. Kurylev
L. Sh. Akhmetova
О. V. Limankin
N. G. Neznanov
author_sort R. F. Nasyrova
collection DOAJ
description Schizophrenia is a socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. The basic drugs in these patients are antipsychotics that are highly effective against the positive and negative symptoms of schizophrenia, but at the same time have a wide range of adverse reactions (ARs). The clinical effect and tolerability of antipsychotics are variable and depend on the characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).The paper describes a clinical case of a female patient with schizophrenia who has been noted to be unresponsive to antipsychotic therapy for some years after the onset of the disease. After pharmacogenetic testing, she was found to be homozygous for the nonfunctional allelic variant CYP2D6*4 (1934 G>A, rs3892097), which was the reason for the complete shutdown of isoenzyme 2D6 activity and the development of ARs in the use of initial doses of antipsychotic drugs, as well as for an increase in the severity of ARs with aggravation of psycho-producing symptoms with an even slow titration of the daily dose.
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language Russian
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publisher IMA-PRESS LLC
record_format Article
series Неврология, нейропсихиатрия, психосоматика
spelling doaj-art-2f6b08bfa5744458934dcfc8b67f1dfd2025-08-20T02:16:14ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422018-12-01104889310.14412/2074-2711-2018-4-88-93805Pharmacogenetics of schizophrenia in real clinical practice: a clinical caseR. F. Nasyrova0N. A. Schnaider1K. O. Mironov2G. A. Shipulin3O. P. Dribnokhodova4E. A. Golosov5M. Yu. Tolmachev6B. V. Andreev7A. A. Kurylev8L. Sh. Akhmetova9О. V. Limankin10N. G. Neznanov11V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia; P.P. Kashchenko Saint Petersburg City Mental Hospital OneV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of RussiaCentral Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-BeingCenter for Strategic Planning and Management of Biomedical Health Risks, Ministry of Health of RussiaCentral Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-BeingP.P. Kashchenko Saint Petersburg City Mental Hospital OneV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of RussiaP.P. Kashchenko Saint Petersburg City Mental Hospital One; Saint Petersburg State UniversityP.P. Kashchenko Saint Petersburg City Mental Hospital One; Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of RussiaV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of RussiaP.P. Kashchenko Saint Petersburg City Mental Hospital OneV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia; Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of RussiaSchizophrenia is a socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. The basic drugs in these patients are antipsychotics that are highly effective against the positive and negative symptoms of schizophrenia, but at the same time have a wide range of adverse reactions (ARs). The clinical effect and tolerability of antipsychotics are variable and depend on the characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).The paper describes a clinical case of a female patient with schizophrenia who has been noted to be unresponsive to antipsychotic therapy for some years after the onset of the disease. After pharmacogenetic testing, she was found to be homozygous for the nonfunctional allelic variant CYP2D6*4 (1934 G>A, rs3892097), which was the reason for the complete shutdown of isoenzyme 2D6 activity and the development of ARs in the use of initial doses of antipsychotic drugs, as well as for an increase in the severity of ARs with aggravation of psycho-producing symptoms with an even slow titration of the daily dose.https://nnp.ima-press.net/nnp/article/view/1002pharmacogenomicspharmacogeneticsantipsychoticsschizophreniap-glycoproteincytochrome p450
spellingShingle R. F. Nasyrova
N. A. Schnaider
K. O. Mironov
G. A. Shipulin
O. P. Dribnokhodova
E. A. Golosov
M. Yu. Tolmachev
B. V. Andreev
A. A. Kurylev
L. Sh. Akhmetova
О. V. Limankin
N. G. Neznanov
Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
Неврология, нейропсихиатрия, психосоматика
pharmacogenomics
pharmacogenetics
antipsychotics
schizophrenia
p-glycoprotein
cytochrome p450
title Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
title_full Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
title_fullStr Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
title_full_unstemmed Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
title_short Pharmacogenetics of schizophrenia in real clinical practice: a clinical case
title_sort pharmacogenetics of schizophrenia in real clinical practice a clinical case
topic pharmacogenomics
pharmacogenetics
antipsychotics
schizophrenia
p-glycoprotein
cytochrome p450
url https://nnp.ima-press.net/nnp/article/view/1002
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