SYMPOSIA
SYMPOSIA
SYMPOSIA
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Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Abstracts of the Invited Speakers<br />
Pharmacogenetics and how individualized medicine can be applied to the practice of psychiatry<br />
Çiğdem Aydemir<br />
Ankara Numune Research and Education Hospital, First Psychiatry Clinic, Ankara, Turkey<br />
E-mail: aydemircigdem@yahoo.com<br />
Choice of psychotropic agents is a critical problem during the follow up of mentally ill patients. Some of the patients experience remission,<br />
however significant proportions of the patients continue to suffer from psychiatric symptoms and side or adverse effects.<br />
Psychotropic drug efficiency may not occur until a considerable time after the initiation of the therapy after which the clinician can<br />
determine, whether the regimen is effective or not. During this period treated patients may experience continuous psychiatric symptoms,<br />
employment loss, social dysfunction, and medical morbidity.<br />
Efforts to identify the best possible drug regimen for the patients focused on many points, such as clinical variables, predictors of possible<br />
side effects, plasma and CSF neurotransmitter levels, metabolite levels, and brain imaging, but they have only limited success. Up to date<br />
in practice, drug selection is made based on clinical symptom profile and possible side effects of treatments.<br />
The pharmacogenetics of the psychotropic drugs is a possible way to decide the suitable drug for the patient. Pharmacogenetics is the<br />
study of genetically determined interindividual differences in response to pharmalogical agents. In this field there are genetically coded<br />
pharmacokinetics (genetically based differences that influence the bioavailability of a drug), pharmacodynamics (genetically based<br />
differences in the proteins at which a drug acts) of the drugs, and dynamics of their side effects.<br />
The renal clearance of drugs appears to be similar in age- and weight-matched healthy subjects with no defined genetic polymorphisms.<br />
Studies regarding the inheritance mostly account for the ability to eliminate drugs. The genetic differences in pharmacokinetics have<br />
proved that they may be applied to the most of the drugs metabolism. Genetic polymorphisms have been identified and defined for<br />
some drug transporters, primarily P-gp, and several hepatic enzymes important for the cellular transport and metabolism of many drugs<br />
used in psychopharmacology. Genetic polymorphism in a drug-metabolizing enzyme can result in subpopulations of people who may<br />
deviate from the population mean in their ability to metabolize substrates of the affected enzyme. People who are poor metabolizers<br />
constitute at least 1% of the population, but the majority of people are normal or rapid metabolizers, and some are identified as ultra rapid<br />
metabolizers. The practical implications of metabolic phenotyping are most meaningful when the metabolic pathways of therapeutically<br />
administered drugs are known and when drug concentration has been correlated to either therapeutic or toxic effects.<br />
Genetic differences in the receptors, on which the drugs act, are another important factor in predicting the effects and side effects. Findings<br />
in this field are scarce in comparison to pharmacokinetics studies however some research projects are in progress. After the results of these<br />
studies are obtained; different variables other than plasma concentration of the drug would be available in pharmacotherapy practice.<br />
There is a dramatic increase in the amount of availability of the genetic information in public since samples can be easily collected by<br />
peripheral blood collection or mucosal smearing. Progress in genetic-molecular technology made possible to conduct genetic research<br />
on individual genes or entire genomes. In the future by the help of pharmacogenetic approach clinicians will be able to understand the<br />
predictors of drug efficacy and side effects, as a result individualized medicine will be applied in the practice of psychiatry.<br />
Key words: Pharmacogenetics, psychiatry, treatment, individualized medicine<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S101<br />
Pharmacogenomics biomarkers and personalized medicine in psychiatry<br />
Yeşim Aydın Son<br />
Middle East Technical University, Informatics Institute Department of Health Informatics, 06800, Ankara, Turkey<br />
E-mail: yesim@metu.edu.tr<br />
Transformation of clinical medicine was one of the long term goals of the Human Genome Project, expected to impact the practice<br />
within 10-20 years after the announcement of first draft of human genome. As of 2011 we are just entering into this era and emerging<br />
applications of technologies based on genomic research is indicating that Human Genome Project will be able keep its promise.<br />
Translational and clinical research to develop new personalized medicine approaches are going strongly; identification of predictive and<br />
diagnostic biomarkers is accelerating with the help of high-throughput technologies, and molecular diagnostics and pharmacogenomics<br />
is one of the growing markets worldwide with the goal of early detection, prevention, and intervention of diseases and to predict drug<br />
efficacy to guide dosing and avoid adverse reactions.<br />
S101