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This talk, we
focus on influence of genetic
variants in neurotransmitter
receptors on the response with
treatment with psychotropic drugs.
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The talk is divided into five parts,
starting with a brief introduction.
A second part is dedicated
to genetic variants
in dopamine receptors
and transporters
and the influence on
treatment response.
The third chapter summarizes
the effect of genetic variants
in the serotonergic system, followed
by a chapter on genetic variants
in other neurotransmitter
systems and their influence
on clinical outcome.
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Introduction-- The
mainstay treatment
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of severe mental disorders, such
as schizophrenia and bipolar
disorders, is the use
of psychotropic drugs.
However, not all patients
respond to treatment.
30 to 50% of treated
patients fail to respond.
And about 60 to 70%
of treated patients
develop long lasting
and severe side effects,
which can be life threatening.
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The causes of treatment variability
are a combination of genetic,
environmental, and clinical factors.
A limited number of
family and genetic studies
support the contribution
of genetic factors
to the variability in treatment
response to psychotropic treatment,
although no extensive
treatment study
has been performed to
quantify their contribution.
There is also evidence suggesting
that environmental and clinical
factors influence treatment
response, factors such as smoking,
food, plasma levels, therapeutic
doses, concomitant treatment,
especially when patients are
treated with several drug
substrates for the
same metabolic enzyme.
Ethnicity, age and gender of the
patient, the severity of illness,
all have been suggested to
contribute to treatment response,
however, none of mentioned
clinical and environmental factors
can reliably predict
treatment response.
And it is thought that interaction
between genetic and non-genetic
factors results in
treatment variability.
