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Pharmacogenetics of schizophrenia in real clinical practice: a clinical case

https://doi.org/10.14412/2074-2711-2018-4-88-93

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Abstract

Schizophrenia is a socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. The basic drugs in these patients are antipsychotics that are highly effective against the positive and negative symptoms of schizophrenia, but at the same time have a wide range of adverse reactions (ARs). The clinical effect and tolerability of antipsychotics are variable and depend on the characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).

The paper describes a clinical case of a female patient with schizophrenia who has been noted to be unresponsive to antipsychotic therapy for some years after the onset of the disease. After pharmacogenetic testing, she was found to be homozygous for the nonfunctional allelic variant CYP2D6*4 (1934 G>A, rs3892097), which was the reason for the complete shutdown of isoenzyme 2D6 activity and the development of ARs in the use of initial doses of antipsychotic drugs, as well as for an increase in the severity of ARs with aggravation of psycho-producing symptoms with an even slow titration of the daily dose.

About the Authors

R. F. Nasyrova
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia; P.P. Kashchenko Saint Petersburg City Mental Hospital One
Russian Federation

Regina Faritovna Nasyrova

3, Bekhterev St., Saint Petersburg 192019; 10, Menkovskaya St., Nikolskoe Settlement, Gatchina District, Leningrad Region 188357



N. A. Schnaider
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation

3, Bekhterev St., Saint Petersburg 192019



K. O. Mironov
Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being
Russian Federation

3a, Novogireevskaya St., Moscow 111123



G. A. Shipulin
Center for Strategic Planning and Management of Biomedical Health Risks, Ministry of Health of Russia
Russian Federation

10/1, Pogodinskaya St., Moscow 119121



O. P. Dribnokhodova
Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being
Russian Federation

3a, Novogireevskaya St., Moscow 111123



E. A. Golosov
P.P. Kashchenko Saint Petersburg City Mental Hospital One
Russian Federation

10, Menkovskaya St., Nikolskoe Settlement, Gatchina District, Leningrad Region 188357



M. Yu. Tolmachev
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation

3, Bekhterev St., Saint Petersburg 192019



B. V. Andreev
P.P. Kashchenko Saint Petersburg City Mental Hospital One; Saint Petersburg State University
Russian Federation

10, Menkovskaya St., Nikolskoe Settlement, Gatchina District, Leningrad Region 188357; 7—9, Universitetskaya Embankment, Saint Petersburg 199034



A. A. Kurylev
P.P. Kashchenko Saint Petersburg City Mental Hospital One; Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
Russian Federation

10, Menkovskaya St., Nikolskoe Settlement, Gatchina District, Leningrad Region 188357; 6—8, Lev Tolstoy St., Saint Petersburg 197022



L. Sh. Akhmetova
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation

3, Bekhterev St., Saint Petersburg 192019



О. V. Limankin
P.P. Kashchenko Saint Petersburg City Mental Hospital One
Russian Federation

10, Menkovskaya St., Nikolskoe Settlement, Gatchina District, Leningrad Region 188357



N. G. Neznanov
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of Russia; Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
Russian Federation

3, Bekhterev St., Saint Petersburg 192019; 6—8, Lev Tolstoy St., Saint Petersburg 197022



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For citation:


Nasyrova R.F., Schnaider N.A., Mironov K.O., Shipulin G.A., Dribnokhodova O.P., Golosov E.A., Tolmachev M.Y., Andreev B.V., Kurylev A.A., Akhmetova L.S., Limankin О.V., Neznanov N.G. Pharmacogenetics of schizophrenia in real clinical practice: a clinical case. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):88-93. (In Russ.) https://doi.org/10.14412/2074-2711-2018-4-88-93

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)