Pharmacogenomic Characterization of Childbearing-Aged Individuals With Mood Disorders in a Tertiary Care Perinatal Mental Health Clinic.

Autor:	Mayer JLW; Department of Psychiatry, Allina Health Abbott Northwestern Hospital, Minneapolis, Minnesota.; Corresponding Author: Jessica L. W. Mayer, MD, Department of Psychiatry, Abbott Northwestern Hospital Mental Health Clinic, Allina Health, 800 E 28th St, Minneapolis, MN 55407 (jessica.mayer@allina.com)., Betcher HK; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota., Rasmussen-Torvik LJ; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Yang A; Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois., George AL; Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Abramova T; Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Stika CS; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Wisner KL; Children's National Hospital and George Washington University School of Medicine, Washington, District of Columbia., Clark CT; Department of Psychiatry, University of Toronto, Women's College Hospital, Toronto, Canada., Gollan J; Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	The Journal of clinical psychiatry [J Clin Psychiatry] 2024 Jun 10; Vol. 85 (2). Date of Electronic Publication: 2024 Jun 10.
DOI:	10.4088/JCP.23m15024
Abstrakt:	Objective: The effectiveness of antidepressant treatment for mood disorders is often limited by either a poor response or the emergence of adverse effects. These complications often necessitate multiple drug trials. This clinical challenge intensifies during pregnancy, when medications must be selected to improve the likelihood of response and optimize reproductive outcomes. We determined the distribution of common pharmacogenetic variants, metabolizer phenotypes, past medication responses, and side effects in childbearing-aged individuals seeking treatment in a tertiary care perinatal mental health clinic. Methods: Sixty treatment-seeking women (based on sex at birth) with DSM-5- defined bipolar disorder (n = 28) or major depressive disorder (n = 32) provided DNA samples and completed psychiatric diagnostic and severity assessments between April 2014 and December 2017. Samples were genotyped for single-nucleotide variants in drug metabolizing enzyme genes of commonly prescribed antidepressants (cytochrome P450 [CYP] 1A2, 2B6, 2C9, 2C19, 2D6, 3A4, and 3A5), and the frequency of normative metabolizer status was compared to reference populations data from Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. The Antidepressant Treatment History Form was used to record historic medication trials and side effects. Results: A significantly greater proportion of extensive metabolizers for CYP2B6 was observed in the study population when compared to CPIC population frequency databases in Caucasians (0.64 vs 0.43 [95% CI: 0.49-0.76]; P value = .006) and African Americans (0.71 vs 0.33 [95% CI: 0.29-0.96]; P value = .045). No significant association was found between metabolizer phenotype and the likelihood of a medication side effect. Conclusion: Pharmacogenomic testing may have value for personalized prescribing in individuals capable of or considering pregnancy. (© Copyright 2024 Physicians Postgraduate Press, Inc.)
Databáze:	MEDLINE
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