Personalized pharmacotherapy of psychosis clinical and pharmacogenetic approaches

PhD ceremony: Mr. J. Vehof, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Personalized pharmacotherapy of psychosis clinical and pharmacogenetic approaches

Promotor(s): prof. H. Snieder, prof. R.P. Stolk

Faculty: Medical Sciences

Despite 60 years of antipsychotic drugs, the pharmacotherapy of psychosis is still far from ideal. In particular side-effects, such as weight gain and therapy induced movement disorders, are major problems. The aim of this thesis is to contribute to the development of personalised medicine for the treatment of psychosis through the study of clinical factors in the use of oral and depot antipsychotic drugs, and the pharmacogenetics of antipsychotic response and drug-induced side effects. Several clinical factors were determined that predict which patients switch form oral to depot treatment, including the presence of movement disorders, lack of compliance, and lack of psychiatric co-morbidity. New associations were found between various polymorphisms in receptor genes and metabolic disturbances and movement disorders in patients on antipsychotic medication. The researchers were not able to replicate several associations of polymorphisms that were found in earlier studies. Negative results and lack of replication are common in pharmcogenetic studies of antipsychotic drugs. There is growing evidence that environmental, ethnic and many other factors affect the link between genetic variation and the efficacy of antipsychotic drugs.