CYP2D6 Genotyping and Antipsychotic-Associated Extrapyramidal Adverse Effects in a Randomized Trial of Aripiprazole Versus Quetiapine Extended Release in Children and Adolescents, Aged 12–17 Years, With First Episode Psychosis
| Autor: | Jens Richardt Møllegaard, Thomas Werge, Karsten Gjessing Jensen, Ditte Rudå, Gesche Jürgens, Birgitte Fagerlund, Dea Gowers Klauber, Kristian Linnet, Anne Katrine Pagsberg, Marie Stentebjerg Decara, Anders Fink-Jensen, Christoph U. Correll |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Psychosis business.industry medicine.medical_treatment medicine.disease Akathisia digestive system law.invention Psychiatry and Mental health Tolerability Randomized controlled trial Extrapyramidal symptoms law Internal medicine medicine Quetiapine Pharmacology (medical) Aripiprazole medicine.symptom Antipsychotic business medicine.drug |
| Zdroj: | Journal of Clinical Psychopharmacology. 41:667-672 |
| ISSN: | 1533-712X 0271-0749 |
| DOI: | 10.1097/jcp.0000000000001490 |
| Popis: | Purpose/background The aim of this study was to examine the association between genetically predicted CYP2D6 phenotypes and extrapyramidal symptoms (EPSs). Methods/procedures Data from the Tolerability and Efficacy of Antipsychotics trial of adolescents with first-episode psychosis randomized to aripiprazole versus quetiapine extended release were studied. Extrapyramidal symptom assessments included the Simpson-Angus Scale and the Barnes Akathisia Rating Scale. Patients were CYP2D6 genotyped. Plasma concentrations of antipsychotics and antidepressants were analyzed. Findings/results One hundred thirteen youths (age, 12-17 years; males, 30%; antipsychotic naive, 51%) were enrolled. Poor metabolizers had a significantly higher dose-adjusted aripiprazole plasma concentration (±SD) compared with normal metabolizers at week 4 (24.30 ± 6.40 ng/mL per milligram vs 14.85 ± 6.15 ng/mL per milligram; P = 0.019), but not at week 12 (22.15 ± 11.04 ng/mL per milligram vs 14.32 ± 4.52 ng/mL per milligram; P = 0.067). This association was not found in the quetiapine extended release group. No association between CYP2D6 genotype groups and global Barnes Akathisia Rating Scale score or Simpson-Angus Scale score was found in any of the treatment arms. Implications/conclusions Our results do not support routine use of CYP2D6 testing as a predictor of drug-induced parkinsonism or akathisia risk in clinical settings. Further studies with larger samples of CYP2D6 poor metabolizers are needed. |
| Databáze: | OpenAIRE |
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