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Castaldelli-Maia JM, Camargos de Oliveira V, Irber FM, Blaas IK, Angerville B, Sousa Martins-da-Silva A, Koch Gimenes G, Waisman Campos M, Torales J, Ventriglio A, Guillois C, El Ouazzani H, Gazaix L, Favré P, Dervaux A, Apter G. Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders. Int Rev Psychiatry 2023; 35:397-417. [PMID: 38299651 DOI: 10.1080/09540261.2023.2249084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/14/2023] [Indexed: 02/02/2024]
Abstract
The adverse effects of smoking cessation in individuals with mental health disorders have been a point of concern, and progress in the development of treatment has been slow. The primary first-line treatments for smoking cessation are Nicotine Replacement Therapy, Bupropion, Varenicline, and behavioural support. Nortriptyline and Clonidine are second-line treatments used when the first-line treatments are not effective or are contraindicated. Smoking cessation medications have been shown to be effective in reducing nicotine cravings and withdrawal symptoms and promoting smoking cessation among patients living with mental disorders. However, these medications may have implications for patients' mental health and need to be monitored closely. The efficacy and side effects of these medications may vary depending on the patient's psychiatric condition, medication regimen, substance use, or medical comorbidities. The purpose of this review is to synthesise the pharmacokinetics, pharmacodynamics, therapeutic effects, adverse effects, and pharmacological interactions of first- and second-line smoking cessation drugs, with an emphasis on patients suffering from mental illnesses. Careful consideration of the risks and benefits of using smoking cessation medications is necessary, and treatment plans must be tailored to individual patients' needs. Monitoring symptoms and medication regimens is essential to ensure optimal treatment outcomes.
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Affiliation(s)
- João Mauricio Castaldelli-Maia
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Israel K Blaas
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Gislaine Koch Gimenes
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, FLENI, Buenos Aires, Argentina
| | - Julio Torales
- Department of Psychiatry, National University of Asuncion, San Lorenzo, Paraguay
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
- School of Health Sciences, Universidad Sudamericana, Pedro Juan Caballero, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carine Guillois
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Houria El Ouazzani
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Léna Gazaix
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Pascal Favré
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
| | - Alain Dervaux
- Établissement Public de Santé Barthélémy Durand, Étampes, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Gisèle Apter
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
- Societé de l'Information Psychiatrique, Bron, France
- University of Rouen Normandy, Rouen, France
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2
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Alvarado AT, Saravia M, Losno R, Pariona R, Muñoz AM, Ybañez-Julca RO, Loja B, Bendezú MR, García JA, Surco-Laos F, Laos-Anchante D, Chávez H, Aguilar P, Pineda M. CYP2D6 and CYP2C19 Genes Associated with Tricontinental and Latin American Ancestry of Pe-ruvians. DRUG METABOLISM AND BIOANALYSIS LETTERS 2022; 16:DMBL-EPUB-128245. [PMID: 36518034 PMCID: PMC10436705 DOI: 10.2174/1872312815666221213151140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/30/2022] [Accepted: 10/14/2022] [Indexed: 06/17/2023]
Abstract
Precision medicine seeks to individualize the dose from the beginning of phar-macological therapy based on the characteristics of each patient, genes involved in the metabolic phenotype, ethnicity or miscegenation, with the purpose to minimize adverse effects and optimize drug efficacy. The objective was to re-view studies that describe the association of the CYP2D6 and CYP2C19 genes with the tricontinental and Latin American ancestry of Peruvians. A biblio-graphic search was carried out in PubMed/Medline and SciELO, with various descriptors in Spanish and English. The results of this review confirm that the ethnic origin of Peruvians is triconti-nental due to European (mainly Spanish), African and Asian migration, in addi-tion to Latin American migration, being 60.2% mixed, 25.8% Amerindian, 5.9% white, 3.6% African descent, 1.2% Chinese and Japanese descent, and 3.3% unspecified. Studies on CYP2C19*3, CYP2D6*2, *3 and *6 have been reported in Peruvians, and the frequency is similar to that studied in Ecuadori-ans and Colombians. The CYP2C19*3, CYP2D6*3, and CYP2D6*6 alleles found in Peruvians are common in Europeans, Africans, and Asians; while CYP2D6*4 in Africans and CYP2D6*2 related to Asians. In some studies, the ethnic/gene association has not been demonstrated; while others have shown a significant association, which is why further investigation is warranted. It is concluded that the studies on CYP2D6 and CYP2C19 genes associated with the tricontinental and Latin American ancestry of Peruvians are little, and ac-cording to what has been investigated, the CYP2C19*3, CYP2D6*2, *3, *4 and *6 alleles have more related to their ancestry.
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Affiliation(s)
- Angel T. Alvarado
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Madrid, 28001, Spain
| | - María Saravia
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ricardo Losno
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ricardo Pariona
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Ana María Muñoz
- Institute of Food Science and Nutrition, ICAN, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - Roberto O. Ybañez-Julca
- Faculty of Pharmacy and Biochemistry, National University of Trujillo, Trujillo, 13001, Peru
| | - Berta Loja
- International Research Network in Pharmacology and Precision Medicine, Human Medicine School, San Ignacio de Loyola University, USIL, Lima, 15024, Peru
| | - María R. Bendezú
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Jorge A. García
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Felipe Surco-Laos
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Doris Laos-Anchante
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | - Haydee Chávez
- Faculty of Pharmacy and Biochemistry, San Luis Gonzaga National University of Ica, Ica, 11001, Peru
| | | | - Mario Pineda
- Pharmacy and Biochemistry, FCS, Scientific of the South University, UCSUR, Lima, 15067, Peru
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3
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Di Nunno N, Esposito M, Argo A, Salerno M, Sessa F. Pharmacogenetics and Forensic Toxicology: A New Step towards a Multidisciplinary Approach. TOXICS 2021; 9:292. [PMID: 34822683 PMCID: PMC8620299 DOI: 10.3390/toxics9110292] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/20/2021] [Accepted: 11/02/2021] [Indexed: 01/24/2023]
Abstract
Pharmacogenetics analyzes the individual behavior of DNA genes after the administration of a drug. Pharmacogenetic research has been implemented in recent years thanks to the improvement in genome sequencing techniques and molecular genetics. In addition to medical purposes, pharmacogenetics can constitute an important tool for clarifying the interpretation of toxicological data in post-mortem examinations, sometimes crucial for determining the cause and modality of death. The purpose of this systematic literature review is not only to raise awareness among the forensic community concerning pharmacogenetics, but also to provide a workflow for forensic toxicologists to follow in cases of unknown causes of death related to drug use/abuse. The scientific community is called on to work hard in order to supply evidence in forensic practice, demonstrating that this investigation could become an essential tool both in civil and forensic contexts. The following keywords were used for the search engine: (pharmacogenetics) AND (forensic toxicology); (pharmacogenetics) AND (post-mortem); (pharmacogenetics) AND (forensic science); and (pharmacogenetics) AND (autopsy). A total of 125 articles were collected. Of these, 29 articles were included in this systematic review. A total of 75% of the included studies were original articles (n = 21) and 25% were case reports (n = 7). A total of 78% (n = 22) of the studies involved deceased people for whom a complete autopsy was performed, while 22% (n = 6) involved people in good health who were given a drug with a subsequent pharmacogenetic study. The most studied drugs were opioids (codeine, morphine, and methadone), followed by antidepressants (tricyclic antidepressants and venlafaxine). Furthermore, all studies highlighted the importance of a pharmacogenetics study in drug-related deaths, especially in cases of non-overdose of drugs of abuse. This study highlights the importance of forensic pharmacogenetics, a field of toxicology still not fully understood, which is of great help in cases of sudden death, deaths from overdose, deaths after the administration of a drug, and also in cases of complaint of medical malpractice.
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Affiliation(s)
- Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy
| | - Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy
| | - Antonina Argo
- Department of Health Promotion Sciences, Section of Legal Medicine, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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4
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Shalimova A, Babasieva V, Chubarev VN, Tarasov VV, Schiöth HB, Mwinyi J. Therapy response prediction in major depressive disorder: current and novel genomic markers influencing pharmacokinetics and pharmacodynamics. Pharmacogenomics 2021; 22:485-503. [PMID: 34018822 DOI: 10.2217/pgs-2020-0157] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Major depressive disorder is connected with high rates of functional disability and mortality. About a third of the patients are at risk of therapy failure. Several pharmacogenetic markers especially located in CYP450 genes such as CYP2D6 or CYP2C19 are of relevance for therapy outcome prediction in major depressive disorder but a further optimization of predictive tools is warranted. The article summarizes the current knowledge on pharmacogenetic variants, therapy effects and side effects of important antidepressive therapeutics, and sheds light on new methodological approaches for therapy response estimation based on genetic markers with relevance for pharmacokinetics, pharmacodynamics and disease pathology identified in genome-wide association study analyses, highlighting polygenic risk score analysis as a tool for further optimization of individualized therapy outcome prediction.
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Affiliation(s)
- Alena Shalimova
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, 751 24, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Viktoria Babasieva
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, 751 24, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Vladimir N Chubarev
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Vadim V Tarasov
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia.,Institute of Translational Medicine & Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, 751 24, Sweden.,Institute of Translational Medicine & Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Jessica Mwinyi
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, 751 24, Sweden
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5
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Wiedfeld C, Skopp G, Musshoff F. Single hair analysis: Validation of a screening method for over 150 analytes and application on documented single-dose cases. Drug Test Anal 2021; 13:817-832. [PMID: 33448136 DOI: 10.1002/dta.2997] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/11/2020] [Accepted: 01/06/2021] [Indexed: 12/16/2022]
Abstract
Hair is the matrix of choice in forensic toxicology when retrospective analysis is needed. Nonetheless, due to misalignment, different growth stages and segmentation lengths of 0.5-1 cm, resolution of time is limited. By segmental analysis of single hairs, most of these factors can be compensated and resolution of time is enhanced. A method for manually segmenting single hairs in 2-mm sections and screening for 156 analytes by liquid chromatography coupled to tandem mass spectrometry has been developed and validated. The method was applied to 15 single-dose cases concerning different pharmaceuticals by analyzing 10 hairs each, sampled 1 and 2 months after ingestion in most cases. The validation showed a lower limit of quantification of ≤1.25 pg/segment for ~90% of analytes and good accuracy. Many substances could be detected in the presented cases, whereas detection of benzodiazepines and low dosed opioids remains challenging. In positive cases, characteristic peak-shaped concentration profiles across the hairs were obtained. The segment with most coinciding peak maxima can be allocated to the time of ingestion. A method for the determination of individual hair growth rate was applied and revealed a gap between expected and actual position of peak maxima. Additionally, different localization of simultaneously administered substances was observed. These findings were tried to be explained by different routes of incorporation and may contribute to current knowledge. The presented method may directly be applied to similar questions in hair analysis, and the findings are considered important for interpreting further results in single hair analysis.
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Affiliation(s)
| | - Gisela Skopp
- Forensic Toxicological Center (FTC) Munich, Munich, Germany
| | - Frank Musshoff
- Forensic Toxicological Center (FTC) Munich, Munich, Germany
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Claudio-Campos K, Padrón A, Jerkins G, Nainaparampil J, Nelson R, Martin A, Wiisanen K, Smith DM, Strekalova Y, Marsiske M, Cicali EJ, Cavallari LH, Mathews CA. Acceptability, Feasibility, and Utility of Integrating Pharmacogenetic Testing into a Child Psychiatry Clinic. Clin Transl Sci 2020; 14:589-598. [PMID: 33166056 PMCID: PMC7993320 DOI: 10.1111/cts.12914] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/06/2020] [Indexed: 12/16/2022] Open
Abstract
Pharmacogenetic (PGx) testing is a tool to identify patients at a higher risk of adverse events or treatment failure. The concern for unwanted side effects can limit medication adherence, particularly in children and adolescents. We conducted a pragmatic study to evaluate the acceptability and feasibility and gather pilot data on the utility of PGx testing in a child and adolescent psychiatry clinic. Both physicians and families participated in the study and answered pre‐survey and post‐survey questionnaires to examine their attitudes toward PGx testing. Patients were randomized into implementation (N = 25) and control groups (N = 24) and underwent PGx testing at the beginning or end of the study, respectively. Clinical consult notes with genotype‐guided recommendations were provided to physicians for their consideration in clinical decisions. Patient‐reported symptom severity and antidepressant‐related side effects were assessed at baseline and for 12 weeks. Both participating physicians and families agreed that PGx testing is a useful tool to improve medication selection. The time from sample collection to having PGx test results was ~ 10 days and 15 days to having consult notes available, which may have impaired test utility in clinical decision making. There were no differences in any clinical end point between the implementation and control arms; however, there were higher antidepressant side effect scores for CYP2D6 poor and intermediate metabolizers after the eighth week of treatment. Our findings revealed benefits and pitfalls with the use of PGx testing in the real‐world clinical setting, which may inform the methodology of a larger trial focused on outcomes.
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Affiliation(s)
- Karla Claudio-Campos
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Adaixa Padrón
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Gabriel Jerkins
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jaison Nainaparampil
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA.,Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Robyn Nelson
- Department of Psychiatry, College of Medicine, Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, Florida, USA
| | - Anna Martin
- Department of Psychiatry, College of Medicine, Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, Florida, USA
| | - Kristin Wiisanen
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | | | - Yulia Strekalova
- College of Journalism and Communications, University of Florida, Gainesville, Florida, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Emily J Cicali
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Larisa H Cavallari
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Carol A Mathews
- Department of Psychiatry, College of Medicine, Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, Florida, USA
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Maruf AA, Greenslade A, Arnold PD, Bousman C. Antidepressant pharmacogenetics in children and young adults: A systematic review. J Affect Disord 2019; 254:98-108. [PMID: 31112844 DOI: 10.1016/j.jad.2019.05.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/25/2019] [Accepted: 05/12/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Antidepressants are frequently prescribed and are the first-line pharmacological treatments for psychiatric disorders in children and adolescents. Although antidepressants are generally effective and well-tolerated by children, between 31% to 48% will not respond and up to 25% will experience an adverse drug reaction. Evidence from adult populations suggests pharmacogenetic information can assist with identifying individuals at greatest risk for poor response or adverse drug reactions but the evidence base in pediatric populations is less clear. METHOD We systematically identified, reviewed, and critically evaluated the antidepressant pharmacogenetics literature among children and adolescents using standardized tools and consensus criteria. RESULTS We identified 24 studies, most of which were of fair to moderate quality. Collectively, the studies identified 25 significant gene-antidepressant associations involving 10 genes (ABCB1, BDNF, CYP2C19, CYP2D6, FKBP5, GNB3, HTR1B, HTR2A, SLC6A4, TPH2) and nine antidepressants (amitriptyline, citalopram, escitalopram, fluoxetine, fluvoxamine, nortriptyline, paroxetine, sertraline, and venlafaxine). None of the identified associations have been independently replicated in children. LIMITATIONS Included studies were heterogenous in terms of study design, genes and drugs assessed, and outcomes measured. CONCLUSION The antidepressant pharmacogenetics knowledge base in pediatric populations is still emerging, but results to date echo many of the gene-antidepressant associations identified in adult populations. Given ubiquitous prescribing of antidepressants in the care of children and adolescents with psychiatric disorders, further research on identifying new and confirming current gene-antidepressant associations are warranted.
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Affiliation(s)
- Abdullah Al Maruf
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Alexandra Greenslade
- Department of Kinesiology, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Paul D Arnold
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Department of Psychiatry, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Department of Medical Genetics, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Chad Bousman
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Department of Psychiatry, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Department of Medical Genetics, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Department of Physiology and Pharmacology, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada; Alberta Children's Hospital Research Institute, Cumming School of Medicine, Univeristy of Calgary, Calgary, AB, T2N 4N1, Canada.
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8
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Koh A, Pak KC, Choi HY, Ryu S, Choi SE, Kim KS, Bae KS, Lim HS. Quantitative Modeling Analysis Demonstrates the Impact of CYP2C19
and CYP2D6
Genetic Polymorphisms on the Pharmacokinetics of Amitriptyline and Its Metabolite, Nortriptyline. J Clin Pharmacol 2018; 59:532-540. [DOI: 10.1002/jcph.1344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/29/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Ara Koh
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Center; Seoul Korea
- University of Ulsan College of Medicine; Seoul Korea
| | - Kwan Cheol Pak
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Center; Seoul Korea
- University of Ulsan College of Medicine; Seoul Korea
| | - Hee Youn Choi
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Center; Seoul Korea
| | - Sunae Ryu
- Clinical Research Division; National Institute of Food and Drug Safety Evaluation; Cheongju-si Korea
| | - Seung-eun Choi
- Clinical Research Division; National Institute of Food and Drug Safety Evaluation; Cheongju-si Korea
| | - Ki Soon Kim
- Clinical Research Division; National Institute of Food and Drug Safety Evaluation; Cheongju-si Korea
| | - Kyun-Seop Bae
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Center; Seoul Korea
- University of Ulsan College of Medicine; Seoul Korea
| | - Hyeong-Seok Lim
- Department of Clinical Pharmacology and Therapeutics; Asan Medical Center; Seoul Korea
- University of Ulsan College of Medicine; Seoul Korea
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Abstract
Adverse drug reactions (ADRs) are a major public health concern and cause significant patient morbidity and mortality. Pharmacogenomics is the study of how genetic polymorphisms affect an individual's response to pharmacotherapy at the level of a whole genome. This article updates our knowledge on how genetic polymorphisms of important genes alter the risk of ADR occurrence after an extensive literature search. To date, at least 244 pharmacogenes identified have been associated with ADRs of 176 clinically used drugs based on PharmGKB. At least 28 genes associated with the risk of ADRs have been listed by the Food and Drug Administration as pharmacogenomic biomarkers. With the availability of affordable and reliable testing tools, pharmacogenomics looks promising to predict, reduce, and minimize ADRs in selected populations.
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10
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An optimized and validated SPE-LC–MS/MS method for the determination of caffeine and paraxanthine in hair. Talanta 2015; 144:62-70. [DOI: 10.1016/j.talanta.2015.05.084] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/28/2015] [Accepted: 05/30/2015] [Indexed: 01/30/2023]
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11
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De Kesel PMM, Lambert WE, Stove CP. Alternative Sampling Strategies for Cytochrome P450 Phenotyping. Clin Pharmacokinet 2015; 55:169-84. [DOI: 10.1007/s40262-015-0306-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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12
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De Kesel PMM, Lambert WE, Stove CP. Paraxanthine/Caffeine Concentration Ratios in Hair: An Alternative for Plasma-Based Phenotyping of Cytochrome P450 1A2? Clin Pharmacokinet 2015; 54:771-81. [DOI: 10.1007/s40262-015-0237-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Poetzsch M, Steuer AE, Roemmelt AT, Baumgartner MR, Kraemer T. Single Hair Analysis of Small Molecules Using MALDI-Triple Quadrupole MS Imaging and LC-MS/MS: Investigations on Opportunities and Pitfalls. Anal Chem 2014; 86:11758-65. [DOI: 10.1021/ac503193w] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Poetzsch
- University of Zurich, Institute of Forensic Medicine, Department of Forensic Pharmacology & Toxicology, Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland
| | - Andrea E. Steuer
- University of Zurich, Institute of Forensic Medicine, Department of Forensic Pharmacology & Toxicology, Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland
| | - Andreas T. Roemmelt
- University of Zurich, Institute of Forensic Medicine, Department of Forensic Pharmacology & Toxicology, Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland
| | - Markus R. Baumgartner
- University of Zurich, Institute of Forensic Medicine, Department of Forensic Pharmacology & Toxicology, Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland
| | - Thomas Kraemer
- University of Zurich, Institute of Forensic Medicine, Department of Forensic Pharmacology & Toxicology, Winterthurerstrasse 190/52, CH-8057 Zurich, Switzerland
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Spina E, de Leon J. Clinical applications of CYP genotyping in psychiatry. J Neural Transm (Vienna) 2014; 122:5-28. [DOI: 10.1007/s00702-014-1300-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/18/2014] [Indexed: 12/13/2022]
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15
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Abstract
The use of alternative matrices such as oral fluid and hair has increased in the past decades because of advances in analytical technology. However, there are still many issues that need to be resolved. Standardized protocols of sample pretreatment are needed to link the detected concentrations to final conclusions. The development of suitable proficiency testing schemes is required. Finally, interpretation issues such as link to effect, adulteration, detection markers and thresholds will hamper the vast use of these matrices. Today, several niche areas apply these matrices with success, such as drugs and driving for oral fluid and drug-facilitated crimes for hair. Once those issues are resolved, the number of applications will markedly grow in the future.
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Poetzsch M, Baumgartner MR, Steuer AE, Kraemer T. Segmental hair analysis for differentiation of tilidine intake from external contamination using LC-ESI-MS/MS and MALDI-MS/MS imaging. Drug Test Anal 2014; 7:143-9. [DOI: 10.1002/dta.1674] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/25/2014] [Accepted: 04/25/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Michael Poetzsch
- Department of Forensic Pharmacology and Toxicology; ZIFM - Zurich Institute of Forensic Medicine, University of Zurich; Zurich (Switzerland)
| | - Markus R. Baumgartner
- Department of Forensic Pharmacology and Toxicology; ZIFM - Zurich Institute of Forensic Medicine, University of Zurich; Zurich (Switzerland)
| | - Andrea E. Steuer
- Department of Forensic Pharmacology and Toxicology; ZIFM - Zurich Institute of Forensic Medicine, University of Zurich; Zurich (Switzerland)
| | - Thomas Kraemer
- Department of Forensic Pharmacology and Toxicology; ZIFM - Zurich Institute of Forensic Medicine, University of Zurich; Zurich (Switzerland)
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Interaction of valproic acid and amitriptyline: analysis of therapeutic drug monitoring data under naturalistic conditions. J Clin Psychopharmacol 2013; 33:561-4. [PMID: 23775047 DOI: 10.1097/jcp.0b013e3182905d42] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Amitriptyline (AMI) and valproic acid (VPA) are common psychotropic drugs which are frequently used in psychiatry and also administered in neurology or anesthesia in the absence of a psychiatric indication. On the basis of the case of a 73-year-old man with therapy-resistant major depressive episode who experienced anticholinergic delirium after adding VPA to AMI, we retrospectively analyzed therapeutic drug monitoring data of the years 2008 to 2010. We assessed cases receiving a combination of AMI and VPA, and obtained a control sample of AMI patients without VPA which were matched for sex, age, daily dose, and comedication. Both samples were compared regarding the serum levels of AMI and nortriptyline (NOR) as well as the ratio of NOR and AMI with the Mann-Whitney U test. The combination of AMI and VPA led to a remarkable increase of AMI and NOR serum levels. When comparing 33 patients who received comedication with VPA versus 33 matched controls, the total concentration by combining mean AMI and NOR serum levels (237.1 [119.9] vs 126.4 [52.8] ng/mL) and NOR/AMI ratio (1.300 [0.905] vs 0.865 [0.455]) was significantly higher. Both AMI and VPA are widely prescribed drugs. A combination of both is common for psychiatric or neurologic patients. A cautious dosing of AMI with VPA comedication is advisable, and therapeutic drug monitoring should be performed because this combination may lead to a remarkable increase of AMI and NOR serum levels.
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18
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Thieme D, Baumer C, Sachs H, Teske J. Screening and long-term retrospection for psychoactive drugs in presumptive drug-facilitated crimes using segmented single hairs. Drug Test Anal 2013; 5:736-40. [DOI: 10.1002/dta.1502] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 05/16/2013] [Accepted: 05/25/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Detlef Thieme
- Institute of Doping Analysis and Sports Biochemistry; Dresdner Str. 12; 01731; Kreischa; Germany
| | - Carina Baumer
- Bavarian State Criminal Police Office; Maillingerstr. 15; 80636; Munich; Germany
| | - Hans Sachs
- FTC GmbH; Bayerstr. 53; 80335; Munich; Germany
| | - Joerg Teske
- Institute of Legal Medicine of the Hannover Medical School (MHH); Carl-Neuberg-Str. 1; D-30625; Hannover; Germany
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19
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Abstract
Multidrug resistance P-glycoprotein (P-gp; also known as MDR1 and ABCB1) is expressed in the luminal membrane of the small intestine and blood-brain barrier, and the apical membranes of excretory cells such as hepatocytes and kidney proximal tubule epithelia. P-gp regulates the absorption and elimination of a wide range of compounds, such as digoxin, paclitaxel, HIV protease inhibitors and psychotropic drugs. Its substrate specificity is as broad as that of cytochrome P450 (CYP) 3A4, which encompasses up to 50 % of the currently marketed drugs. There has been considerable interest in variations in the ABCB1 gene as predictors of the pharmacokinetics and/or treatment outcomes of several drug classes, including antidepressants and antipsychotics. Moreover, P-gp-mediated transport activity is saturable, and is subject to modulation by inhibition and induction, which can affect the pharmacokinetics, efficacy or safety of P-gp substrates. In addition, many of the P-gp substrates overlap with CYP3A4 substrates, and several psychotropic drugs that are P-gp substrates are also CYP3A4 substrates. Therefore, psychotropic drugs that are P-gp substrates may cause a drug interaction when P-gp inhibitors and inducers are coadministered, or when psychotropic drugs or other medicines that are P-gp substrates are added to a prescription. Hence, it is clinically important to accumulate data about drug interactions through studies on P-gp, in addition to CYP3A4, to assist in the selection of appropriate psychotropic medications and in avoiding inappropriate combinations of therapeutic agents. There is currently insufficient information available on the psychotropic drug interactions related to P-gp, and therefore we summarize the recent clinical data in this review.
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Affiliation(s)
- Yumiko Akamine
- Department of Hospital Pharmacy, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
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Serin A, Canan H, Alper B, Gulmen. M. The frequencies of mutated alleles of CYP2D6 gene in a Turkish population. Forensic Sci Int 2012; 222:332-4. [DOI: 10.1016/j.forsciint.2012.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 07/15/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022]
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21
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Porcelli S, Fabbri C, Spina E, Serretti A, De Ronchi D. Genetic polymorphisms of cytochrome P450 enzymes and antidepressant metabolism. Expert Opin Drug Metab Toxicol 2011; 7:1101-15. [PMID: 21736534 DOI: 10.1517/17425255.2011.597740] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The cytochrome P450 (CYP) enzymes are the major enzymes responsible for Phase I reactions in the metabolism of several substances, including antidepressant medications. Thus, it has been hypothesized that variants in the CYP network may influence antidepressant efficacy and safety. Nonetheless, data on this field are still contradictory. The authors aim to give an overview of the published studies analyzing the influence of CYP highly polymorphic loci on antidepressant treatment in order to translate the acquired knowledge to a clinical level. AREAS COVERED The authors collected and compared experimental works and reviews published from the 1980s to the present and included in the Medline database. The included studies pertain to the effects of CYP gene polymorphisms on antidepressant pharmacokinetic parameters and clinical outcomes (response and drug-related adverse effects), with a focus on applications in clinical practice. The authors focused mainly on in vivo studies in humans (patients or healthy volunteers). EXPERT OPINION Great variability in antidepressant metabolism among individuals has been demonstrated. Thus, with the current interest in individualized medicine, several genetic tests to detect CYP variants have been produced. They provide a potentially useful way to anticipate some clinical outcomes of antidepressant treatment, although they will only be extensively used in clinical practice if precise and specific treatment options and guidelines based on genetic tests can be provided.
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Abstract
Large inter-individual variability in drug response and toxicity, as well as in drug concentrations after application of the same dosage, can be of genetic, physiological, pathophysiological, or environmental origin. Absorption, distribution and metabolism of a drug and interactions with its target often are determined by genetic differences. Pharmacokinetic and pharmacodynamic variations can appear at the level of drug metabolizing enzymes (e.g., the cytochrome P450 system), drug transporters, drug targets or other biomarker genes. Pharmacogenetics or toxicogenetics can therefore be relevant in forensic toxicology. This review presents relevant aspects together with some examples from daily routines.
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Changes in antidepressant metabolism in pregnancy evidenced by metabolic ratios in hair: A novel approach. Forensic Sci Int 2010; 196:93-6. [DOI: 10.1016/j.forsciint.2009.12.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 08/12/2009] [Indexed: 11/21/2022]
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Hair as a Novel Noninvasive Method to Study the Impact of Pregnancy on CYP2D6 Metabolizing Capacity. Ther Drug Monit 2009; 31:531-2. [DOI: 10.1097/ftd.0b013e3181b3580b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Mützel (Rauch) E, Lehn C, Peschel O, Hölzl S, Roßmann A. Assignment of unknown persons to their geographical origin by determination of stable isotopes in hair samples. Int J Legal Med 2008; 123:35-40. [DOI: 10.1007/s00414-008-0286-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Accepted: 09/09/2008] [Indexed: 11/28/2022]
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26
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Cocaine and opiate concentrations in hair from subjects in a heroin maintenance program in comparison to a methadone substituted group. Int J Legal Med 2008; 123:363-9. [DOI: 10.1007/s00414-008-0272-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Accepted: 06/26/2008] [Indexed: 11/26/2022]
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