{"title":"精神病学中的预测性药物基因测试:利与弊","authors":"A. Y. Avilov, A. V. Kidyaeva, E. Vaiman","doi":"10.52667/10.52667/2712-9179-2024-4-1-40-49","DOIUrl":null,"url":null,"abstract":"Pharmacogenetic testing (PGx) is an important diagnostic tool for achieving an optimal balance between the effectiveness and safety of psychotropic drugs, especially those requiring long-term use. The most prescribed medications in psychiatric practice are antipsychotics (APs). Despite the long period of use of APs, their safety profile remains insufficiently high. Due to the high incidence of adverse drug reactions (ADRs), from the central nervous system (CNS) and other organs and tissues of the human body. Therapeutic drug monitoring can help predict and diagnose AP-induced ADRs only if the patient is receiving APs. PGx helps to individually select an AP, its dose and clarify the risk of ADRs before prescribing an AP, or at the start of therapy. This explains the importance of PGx in psychiatrist practice. However, to date, most practicing psychiatrists rarely use predictive PGx or do not use this method. PGx is more often prescribed in the case of a long history of un-successful AP-therapy, or in the case of the development of serious ADRs, the risk of which could be significantly reduced if predictive PGx was used. This case report of PGx in a 56-year-old woman with severe bipolar disorder demonstrates that the trajectory of ADRs and socialization could be significantly improved if this method was prescribed before the initiation of APs, rather than in the event of the development of serious ADRs.","PeriodicalId":414041,"journal":{"name":"Personalized Psychiatry and Neurology","volume":"113 30","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive Pharmacogenetic Testing in Psychiatry: Pros and Cons\",\"authors\":\"A. Y. Avilov, A. V. Kidyaeva, E. Vaiman\",\"doi\":\"10.52667/10.52667/2712-9179-2024-4-1-40-49\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Pharmacogenetic testing (PGx) is an important diagnostic tool for achieving an optimal balance between the effectiveness and safety of psychotropic drugs, especially those requiring long-term use. The most prescribed medications in psychiatric practice are antipsychotics (APs). Despite the long period of use of APs, their safety profile remains insufficiently high. Due to the high incidence of adverse drug reactions (ADRs), from the central nervous system (CNS) and other organs and tissues of the human body. Therapeutic drug monitoring can help predict and diagnose AP-induced ADRs only if the patient is receiving APs. PGx helps to individually select an AP, its dose and clarify the risk of ADRs before prescribing an AP, or at the start of therapy. This explains the importance of PGx in psychiatrist practice. However, to date, most practicing psychiatrists rarely use predictive PGx or do not use this method. PGx is more often prescribed in the case of a long history of un-successful AP-therapy, or in the case of the development of serious ADRs, the risk of which could be significantly reduced if predictive PGx was used. This case report of PGx in a 56-year-old woman with severe bipolar disorder demonstrates that the trajectory of ADRs and socialization could be significantly improved if this method was prescribed before the initiation of APs, rather than in the event of the development of serious ADRs.\",\"PeriodicalId\":414041,\"journal\":{\"name\":\"Personalized Psychiatry and Neurology\",\"volume\":\"113 30\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Personalized Psychiatry and Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52667/10.52667/2712-9179-2024-4-1-40-49\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Personalized Psychiatry and Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52667/10.52667/2712-9179-2024-4-1-40-49","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
药物基因学检测(PGx)是一种重要的诊断工具,可在精神药物(尤其是需要长期使用的药物)的有效性和安全性之间实现最佳平衡。精神科处方最多的药物是抗精神病药物(APs)。尽管抗精神病药物的使用时间很长,但其安全性仍然不够高。由于药物不良反应(ADRs)的发生率很高,这些不良反应来自中枢神经系统(CNS)以及人体的其他器官和组织。只有当患者正在接受 APs 治疗时,治疗药物监测才能帮助预测和诊断 AP 引起的 ADR。PGx 有助于在处方 AP 之前或开始治疗时单独选择 AP 及其剂量,并明确 ADR 的风险。这说明了 PGx 在精神科医生实践中的重要性。然而,迄今为止,大多数执业精神科医生很少使用预测性 PGx 或不使用这种方法。PGx 通常是在 AP 治疗长期不成功或出现严重 ADR 的情况下开出的处方,而如果使用预测性 PGx,则可大大降低出现 ADR 的风险。本病例报告对一名 56 岁的严重躁郁症女性患者进行了 PGx 治疗,结果表明,如果在开始 APs 治疗之前就使用这种方法,而不是在出现严重 ADRs 的情况下才使用,那么 ADRs 和社会化的发展轨迹将得到显著改善。
Predictive Pharmacogenetic Testing in Psychiatry: Pros and Cons
Pharmacogenetic testing (PGx) is an important diagnostic tool for achieving an optimal balance between the effectiveness and safety of psychotropic drugs, especially those requiring long-term use. The most prescribed medications in psychiatric practice are antipsychotics (APs). Despite the long period of use of APs, their safety profile remains insufficiently high. Due to the high incidence of adverse drug reactions (ADRs), from the central nervous system (CNS) and other organs and tissues of the human body. Therapeutic drug monitoring can help predict and diagnose AP-induced ADRs only if the patient is receiving APs. PGx helps to individually select an AP, its dose and clarify the risk of ADRs before prescribing an AP, or at the start of therapy. This explains the importance of PGx in psychiatrist practice. However, to date, most practicing psychiatrists rarely use predictive PGx or do not use this method. PGx is more often prescribed in the case of a long history of un-successful AP-therapy, or in the case of the development of serious ADRs, the risk of which could be significantly reduced if predictive PGx was used. This case report of PGx in a 56-year-old woman with severe bipolar disorder demonstrates that the trajectory of ADRs and socialization could be significantly improved if this method was prescribed before the initiation of APs, rather than in the event of the development of serious ADRs.