Pharmacogenetic Guidelines for Psychotropic Drugs: Optimizing Prescriptions in Clinical Practice

Author:

Baldacci Antoine1ORCID,Saguin Emeric1ORCID,Balcerac Alexander2ORCID,Mouchabac Stéphane34ORCID,Ferreri Florian34,Gaillard Raphael5,Colas Marie-Dominique6,Delacour Hervé67,Bourla Alexis3489ORCID

Affiliation:

1. Department of Psychiatry, Bégin Army Instruction Hospital, 94160 Saint-Mandé, France

2. Neurology Unit, Percy Army Instruction Hospital, 92141 Clamart, France

3. Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, 75012 Paris, France

4. ICRIN—Psychiatry (Infrastructure of Clinical Research in Neurosciences—Psychiatry), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France

5. Department of Psychiatry, Pôle Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France

6. Ecole du Val-de-Grâce, Army Health Service, 75005 Paris, France

7. Biological Unit, Bégin Army Instruction Hospital, 94160 Saint-Mandé, France

8. Clariane, Medical Strategy and Innovation Department, 75008 Paris, France

9. NeuroStim Psychiatry Practice, 75005 Paris, France

Abstract

The modalities for prescribing a psychotropic (dose and choice of molecule) are currently unsatisfactory, which can lead to a lack of efficacy of the treatment associated with prolonged exposure of the patient to the symptoms of his or her illness and the side effects of the molecule. In order to improve the quality of treatment prescription, a part of the current biomedical research is dedicated to the development of pharmacogenetic tools for individualized prescription. In this guideline, we will present the genes of interest with level 1 clinical recommendations according to PharmGKB for the two major families of psychotropics: antipsychotics and antidepressants. For antipsychotics, there are CYP2D6 and CYP3A4, and for antidepressants, CYP2B6, CYP2D6, and CYP2C19. The study will focus on describing the role of each gene, presenting the variants that cause functional changes, and discussing the implications for prescriptions in clinical practice.

Publisher

MDPI AG

Subject

Pharmaceutical Science

Reference50 articles.

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5. (2023, May 15). Adverse Effects of Antipsychotic Medications—PubMed, Available online: https://pubmed.ncbi.nlm.nih.gov/20187598/.

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