Aktivita CYP2D6 u pacientů léčených risperidonem
| Title in English | CYP2D6 testing in patients treated with risperidone |
|---|---|
| Authors | |
| Year of publication | 2011 |
| Type | Article in Periodical |
| Magazine / Source | Česká a slovenská psychiatrie |
| MU Faculty or unit | |
| Citation | |
| Field | Other medical specializations |
| Keywords | pharmacogenetics; cytochrome P450; CYP2D6; risperidone; 9-hydroxy-risperidone |
| Description | There is significant interindividual variability in patient reactivity to psychopharmacological treatment. Possibility to predict patient’s response to pharmacological treatment is the focus of pharmacogenetics. One of the promising candidates for pharmacogenetic testing is CYP2D6, enzyme metabolising several psychoactive drugs including antipsychotic risperidone. Risperidone and its metabolite 9-OH-risperidone show considerable differences, one of which is poorer blood-brain barrier permeability of 9-OH-risperidone. CYP2D6 activity can be estimated by genotypization and phenotypization. Phenotypization is able to determine actual level of enzyme activity even if the CYP2D6 activity has been reduced by CYP2D6 inhibitors. Four CYP2D6 phenotypic variants exist. The most frequent is extensive metaboliser. Intermediate metaboliser and poor metaboliser have reduced CYP2D6 activity and according to number of studies there is higher possibility and severity of risperidone adverse effects. The last variety of CYP2D6 phenotype is ultra-rapid metaboliser with possible lower risperidone efficacy. Besides the high number of studies demonstrating effect of CYP2D6 variability, there are studies which did not show its significant impact. Exact amount of CYP2D6 variability effect is therefore still unclear and further studies has to be conducted to find out whether CYP2D6 pharmacological testing has its place in clinical setting. |
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