A significant inter-individual variability can be found in clinical response during antipsychotic drug therapy. In the United Kingdom, up to 30 percent of patients respond inadequately to treatment for chemical imbalances in the brain. Some of the poor response can be can be attributed to poor patient compliance in taking the prescribed medication. However, alterations in genes encoding mediators of drug efficacy may be particularly important. This includes drug metabolizing enzymes, receptor targets, and transporters. These alterations may also be important for treatment-induced side effects
Clozapine (trade name clozaril) is one of the newer antipsychotic medicines used to treat people with schizophrenia. Although clozapine is often more effective than other antipsychotic medicines, it is not suitable for everybody. Clozapine can cause a problem with the white blood cells of some people, and therefore patients take scheduled blood tests. When clozapine is first prescribed, recipients generally go into the hospital so that their reaction (which may include severe side effects) to the drug can be monitored. The amount of time people need to stay in the hospital varies, from several days to three or four weeks.
Does an individual’s genetic make up determine how effective Clozapine is as a treatment and the nature of its side effects? A British research team is engaging pharmacogenetics, or how genes affect the way people respond to medicines, including antidepressants, chemotherapy treatments, asthma drugs, and many others. The ultimate goal of pharmacogenetics research is to help doctors select the most suitable form of drug therapy from the outset.
The Presentation
A presentation concerning “Applications of Pharmacogenetics: Genetics of Clozapine Response as a Model” is being conducted by Dalu Mancama, from the Clinical Neuropharmacology, Institute of Psychiatry, London at the 54th Annual Meeting of the American Association for Clinical Chemistry (AACC). AACC ( http://www.aacc.org/ ) is the scientific organization for clinical laboratory professionals, physicians, and research scientists. Their primary commitment is the understanding of laboratory testing to identify, monitor and treat human disease. More than 11,000 attendees are expected for the meeting, which is being held at the Orange County Convention Center, Orlando, FL, July 28-August 1, 2002.
Dr. Mancama’s presentation will highlight the following from the teams current research:
Conclusion
The British experience finds that future clinical applications rely on development of kit- based protocols for individualized treatment based on genetic profile. This would result in different anti-psychotics with pertinent predictor variables for optimal drug selection resulting in improved clinical management of patients and a significant reduction in treatment costs.
Editor’s Note: To interview Dr. Mancama , please contact Donna Krupa at 703.527.7357 (direct dial), 703.967.2751 (cell) or djkrupa1@aol.com .
Or contact the AACC Newsroom at: 407.685.4215.