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Schizophrenia pp 161–173Cite as

Pharmacogenetics in the Treatment of Schizophrenia

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Abstract

The goal of pharmacogenetics/pharmacogenomics research is to obtain genetic information which predicts drug efficacy and adverse effects applicable to individual patients (i.e., personalized medicine). This is of particular importance in the treatment of schizophrenia, a complex and heterogeneous disorder with multiple independent symptom dimensions (e.g., psychosis, cognitive impairment, negative symptoms) and a diversity of treatment options. Genetic markers which predict efficacy for specific types of psychopathology, cognitive impairment, or related behaviors (e.g., suicide) for specific antipsychotic drugs (APDs) would diminish the need for multiple clinical trials to find the best medication. Similarly, genetic biomarkers which identify vulnerability for particular types of adverse reactions (e.g., tardive dyskinesia, weight gain) would be of great value. Such biomarkers may also clarify the mechanism of action of APDs and facilitate new drug discovery and development. Presently, genetic biomarkers which purport to predict therapeutic response or adverse effects to specific APDs are identified. Among these are biomarkers for the enzymes which metabolize psychotropic drugs (e.g., CYP2D6, CYP1A2, CYP3A4/5); biomarkers of APD-related adverse effects (e.g., weight gain or tardive dyskinesia); and biomarkers predictive of APD response (e.g., the DRD2 gene which codes the dopamine (DA) D2 receptor; SULT4A1-1 which is reported to predict response to olanzapine; and SV2C which is reported to predict inadequate response to olanzapine and quetiapine). Their widespread adoption will follow if successful, prospective clinical trials demonstrate improvement in clinical outcome and establish convenient and cost-effective genotyping to deliver guidance to prescriber and patient.

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Disclosures

Bill W. Massey is Chief Scientific Officer for MyGenesRx and a Shareholder at SureGene and MyGenesRx. He is a previous consultant for Neurotherapeutics and Mallinckrodt. Herbert Y. Meltzer reports the following financial relationships: (1) ownership/investment interests in Suregene, ACADIA, and GlaxoSmithKline; (2) industry activities (such as speaking, advising, consulting, and providing educational programs) with Janssen Pharmaceuticals, Lundbeck Inc., Sunovion Pharmaceuticals Inc. (Dainippon Sumitomo Pharma Co., Ltd.), TEVA, BiolineRx, BI (Boehringer Ingelheim Pharma GmbH & Co. KG), Envivo, and Companion Diagnostics; (3) expert testimony with Janssen; and (4) current grants: Sunovion Novartis, Dainippon Sumitomo, Envivo, NeuroTherapeutics Pharma, Inc., Otsuka, Takeda, Alkermes, Naurex, Inc., and Astellas Research Institute of America.

Jiang Li has no disclosures.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Bill W. Massey, Jiang Li & Herbert Y. Meltzer

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  1. Bill W. Massey
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  2. Jiang Li
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  3. Herbert Y. Meltzer
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Correspondence to Bill W. Massey .

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Editors and Affiliations

  1. Department of Psychiatry, Rush University, Chicago, Illinois, USA

    Philip G. Janicak

  2. UCLA Semel Institute, Los Angeles, California, USA

    Stephen R. Marder

  3. College of Medicine, University of Florida, Gainesville, Florida, USA

    Rajiv Tandon

  4. Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA

    Morris Goldman

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Massey, B.W., Li, J., Meltzer, H.Y. (2014). Pharmacogenetics in the Treatment of Schizophrenia. In: Janicak, P., Marder, S., Tandon, R., Goldman, M. (eds) Schizophrenia. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0656-7_9

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  • DOI: https://doi.org/10.1007/978-1-4939-0656-7_9

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  • Online ISBN: 978-1-4939-0656-7

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