Pharmacogenetics in Child and Adolescent Psychiatry: Background and Evidence-Based Clinical Applications.

IF 1.5 4区医学 Q2 PEDIATRICS Journal of child and adolescent psychopharmacology Pub Date : 2024-02-01 DOI:10.1089/cap.2023.0074

Salma Malik, Pragya Verma, Gualberto Ruaño, Areej Al Siaghy, Azwa Dilawar, Jeffrey R Bishop, Jeffrey R Strawn, Lisa B Namerow

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Abstract

The efficacy and tolerability of psychotropic medications can vary significantly among children and adolescents, and some of this variability relates to pharmacogenetic factors. Pharmacogenetics (PGx) in child and adolescent psychiatry can potentially improve treatment outcomes and minimize adverse drug reactions. This article reviews key pharmacokinetic and pharmacodynamic genes and principles of pharmacogenetic testing and discusses the evidence base for clinical decision-making concerning PGx testing. This article reviews current guidelines from the United States Food and Drug Administration (FDA), the Clinical Pharmacogenetics Implementation Consortium (CPIC), and the Dutch Pharmacogenetics Working Group (DPWG) and explores potential future directions. This review discusses key clinical considerations for clinicians prescribing psychotropic medications in children and adolescents, focusing on antidepressants, antipsychotics, stimulants, norepinephrine reuptake inhibitors, and alpha-2 agonists. Finally, this review synthesizes the practical use of pharmacogenetic testing and clinical decision support systems.

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儿童和青少年精神病学中的药物遗传学：背景与循证临床应用》。

儿童和青少年对精神药物的疗效和耐受性会有很大差异，其中一些差异与药物遗传因素有关。儿童和青少年精神病学中的药物遗传学（PGx）有可能改善治疗效果并最大限度地减少药物不良反应。本文回顾了关键的药代动力学和药效学基因以及药物遗传学检测的原则，并讨论了有关 PGx 检测的临床决策证据基础。本文回顾了美国食品和药物管理局（FDA）、临床药物遗传学实施联合会（CPIC）和荷兰药物遗传学工作组（DPWG）的现行指南，并探讨了潜在的未来发展方向。本综述讨论了临床医生为儿童和青少年开具精神药物处方时的关键临床注意事项，重点关注抗抑郁药、抗精神病药、兴奋剂、去甲肾上腺素再摄取抑制剂和α-2受体激动剂。最后，本综述总结了药物基因检测和临床决策支持系统的实际应用。

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来源期刊

Journal of child and adolescent psychopharmacology 医学-精神病学

CiteScore

3.60

自引率

5.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Child and Adolescent Psychopharmacology (JCAP) is the premier peer-reviewed journal covering the clinical aspects of treating this patient population with psychotropic medications including side effects and interactions, standard doses, and research on new and existing medications. The Journal includes information on related areas of medical sciences such as advances in developmental pharmacokinetics, developmental neuroscience, metabolism, nutrition, molecular genetics, and more. Journal of Child and Adolescent Psychopharmacology coverage includes: New drugs and treatment strategies including the use of psycho-stimulants, selective serotonin reuptake inhibitors, mood stabilizers, and atypical antipsychotics New developments in the diagnosis and treatment of ADHD, anxiety disorders, schizophrenia, autism spectrum disorders, bipolar disorder, eating disorders, along with other disorders Reports of common and rare Treatment Emergent Adverse Events (TEAEs) including: hyperprolactinemia, galactorrhea, weight gain/loss, metabolic syndrome, dyslipidemia, switching phenomena, sudden death, and the potential increase of suicide. Outcomes research.