The Role of Pharmacogenetic Testing in Optimizing Antipsychotic Therapy

Antipsychotic therapy in psychiatric practice can last from several months to many years, which requires the selection of drugs with the greatest effectiveness and the lowest risk of adverse drug reactions for the patient. According to experts, about a quarter of the total variability in response to antipsychotics is of genetic origin. This review analyzes and summarizes the results of domestic and foreign studies of the role of hereditary risk factors that cause a decrease in hepatic metabolism and efflux of antipsychotics due to polymorphism of genes encoding cytochrome P450 isoenzymes and transporter proteins. The key enzymes of antipsychotic metabolism registered for use in Russia and abroad are presented. The prospects of various options for pharmacogenetic testing in reducing the risk of potentially fatal complications in the selection of antipsychotic therapy in clinical practice are assessed.