1
|
Moon JJ, Kim HS, Shim JC, Ahn JM, Jung DU, Kim DJ, Jeong HE, Kim EY, Jeon DW, Kim SJ, Shin JG. Possible genetic biomarker associated with antipsychotic-induced amenorrhea in female patients with schizophrenia. Int Clin Psychopharmacol 2024; 39:29-35. [PMID: 37551597 DOI: 10.1097/yic.0000000000000501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
This study explored the association of pharmacogenomics with antipsychotic-induced amenorrhea in female patients with schizophrenia. A total of 89 female schizophrenia patients aged 18-40 receiving consistent antipsychotics at a consistent dose for more than 3 months were enrolled in this study. Amenorrhea was defined as the absence of menstrual period for 3 months or three periods in a row. Serum levels of prolactin, estradiol, follicle-stimulating hormone, luteinizing hormone, and thyroid-stimulating hormone were measured and Cytochrome P450 2D6, dopamine receptor D2 ( DRD2 ) and estrogen receptor 1 were genotyped. Twenty-two patients with amenorrhea had higher prolactin levels and lower estradiol levels than those without amenorrhea (94.1 vs. 71.5 ng/ml for prolactin; P = 0.044 and 27.0 vs. 46.7 pg/ml for estradiol; P = 0.007, respectively). Multiple logistic regression analysis identified DRD2 -141C deletion [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.01-4.17; P = 0.049] and drugs increasing prolactin levels (OR = 6.17, 95% CI = 1.28-29.64; P = 0.023) as significant covariates for antipsychotic-induced amenorrhea. This study suggests that DRD2 -141C deletion is associated with antipsychotic-induced amenorrhea although further studies are needed.
Collapse
Affiliation(s)
- Jung-Joon Moon
- Department of Psychiatry, Inje University Busan Paik Hospital
| | - Ho-Sook Kim
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine
| | | | - Jung-Mee Ahn
- Department of Psychiatry, Inje University Busan Paik Hospital
| | - Do-Un Jung
- Department of Psychiatry, Inje University Busan Paik Hospital
| | - Dong-Jin Kim
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine
| | - Hye-Eun Jeong
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine
| | - Eun-Young Kim
- Department of Clinical Pharmacology, Inje University Busan Paik Hosptial
| | - Dong-Wook Jeon
- Department of Psychiatry, Inje University Busan Paik Hospital
| | - Sung-Jin Kim
- Department of Psychiatry, Inje University Busan Paik Hospital
| | - Jae-Gook Shin
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine
- Department of Clinical Pharmacology, Inje University Busan Paik Hosptial
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| |
Collapse
|
2
|
Madla CM, Gavins FKH, Merchant HA, Orlu M, Murdan S, Basit AW. Let's talk about sex: Differences in drug therapy in males and females. Adv Drug Deliv Rev 2021; 175:113804. [PMID: 34015416 DOI: 10.1016/j.addr.2021.05.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/04/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022]
Abstract
Professor Henry Higgins in My Fair Lady said, 'Why can't a woman be more like a man?' Perhaps unintended, such narration extends to the reality of current drug development. A clear sex-gap exists in pharmaceutical research spanning from preclinical studies, clinical trials to post-marketing surveillance with a bias towards males. Consequently, women experience adverse drug reactions from approved drug products more often than men. Distinct differences in pharmaceutical response across drug classes and the lack of understanding of disease pathophysiology also exists between the sexes, often leading to suboptimal drug therapy in women. This review explores the influence of sex as a biological variable in drug delivery, pharmacokinetic response and overall efficacy in the context of pharmaceutical research and practice in the clinic. Prospective recommendations are provided to guide researchers towards the consideration of sex differences in methodologies and analyses. The promotion of disaggregating data according to sex to strengthen scientific rigour, encouraging innovation through the personalisation of medicines and adopting machine learning algorithms is vital for optimised drug development in the sexes and population health equity.
Collapse
Affiliation(s)
- Christine M Madla
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Francesca K H Gavins
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Hamid A Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom
| | - Mine Orlu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Sudaxshina Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Abdul W Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom.
| |
Collapse
|
3
|
Koller D, Abad-Santos F. The pharmacogenetics of aripiprazole-induced hyperprolactinemia: what do we know? Pharmacogenomics 2020; 21:571-574. [PMID: 32397867 DOI: 10.2217/pgs-2020-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Dora Koller
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, 28006, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, 28006, Spain.,UICEC Hospital Universitario de La Princesa, Platform SCReN (Spanish Clinical Research Network), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, 28006, Spain
| |
Collapse
|
4
|
Koller D, Belmonte C, Saiz-Rodríguez M, Zubiaur P, Román M, Ochoa D, Abad-Santos F. Effects of aripiprazole on circadian prolactin secretion related to pharmacogenetics in healthy volunteers. Basic Clin Pharmacol Toxicol 2019; 126:236-246. [PMID: 31520576 DOI: 10.1111/bcpt.13323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/10/2019] [Indexed: 01/09/2023]
Abstract
Aripiprazole treatment in schizophrenic patients was previously associated with lower or normalized prolactin levels. Genetic variants in cytochrome P450 (CYP) (CYP2D6), dopamine receptor (DRD2, DRD3) and serotonin receptor (HTR2A, HTR2C) genes were previously associated with antipsychotic-induced hyperprolactinaemia. Our aim was to evaluate whether aripiprazole affects prolactin secretion and its relationship with pharmacogenetics. Thirty-one healthy volunteers receiving a 10-mg single oral dose of aripiprazole were genotyped for 12 polymorphisms in CYP2D6, DRD2, DRD3, HTR2A and HTR2C genes by qPCR. Aripiprazole and dehydro-aripiprazole plasma concentrations were measured by HPLC-MS/MS. Prolactin concentrations of the 31 volunteers taking aripiprazole and 12 volunteers receiving ibuprofen were determined by ELISA. Prolactin concentrations after ibuprofen intake were considered as control, since it is known to cause no effect. Prolactin concentrations were slightly higher in the aripiprazole group compared to the ibuprofen group. All prolactin pharmacokinetic parameters were higher in females than in males. CYP2D6 poor and intermediate metabolizers had notably higher prolactin Cmax and AUC0-12 than normal and ultrarapid metabolizers. The DRD3 rs6280 polymorphism affected prolactin levels: volunteers carrying Ser/Ser genotype had significantly lower prolactin levels than volunteers carrying the Gly allele. Furthermore, HTR2C rs3813929 C/C homozygotes had significantly lower prolactin levels than T allele carriers. Nevertheless, aripiprazole did increase prolactin levels compared to ibuprofen.
Collapse
Affiliation(s)
- Dora Koller
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain
| | - Carmen Belmonte
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain.,UICEC University Hospital of the Princess, Platform SCREN (Spanish Clinical Research Network), Health Research Institute of the Princess (IP), Madrid, Spain
| | - Miriam Saiz-Rodríguez
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain
| | - Pablo Zubiaur
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain
| | - Manuel Román
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain.,UICEC University Hospital of the Princess, Platform SCREN (Spanish Clinical Research Network), Health Research Institute of the Princess (IP), Madrid, Spain
| | - Dolores Ochoa
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain.,UICEC University Hospital of the Princess, Platform SCREN (Spanish Clinical Research Network), Health Research Institute of the Princess (IP), Madrid, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Department, University Hospital of the Princess, Teófilo Hernando Institute, School of Medicine, Health Research Institute of the Princess (IP), Autonomus University of Madrid, Madrid, Spain.,UICEC University Hospital of the Princess, Platform SCREN (Spanish Clinical Research Network), Health Research Institute of the Princess (IP), Madrid, Spain
| |
Collapse
|
5
|
Ma L, Xiang Q, Zhou S, Tan Y, Zhang X, Yang T, Xie Q, Mu G, Zhao X, Zhou Y, Li S, Cui Y. Association of dopamine D2 receptor gene polymorphisms with prolactin levels related to risperidone treatment: A systematic review and meta-analysis. J Clin Pharm Ther 2019; 44:543-552. [PMID: 31056781 DOI: 10.1111/jcpt.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/20/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Dopamine D2 receptor (DRD2) polymorphisms are inconsistently associated with elevated prolactin levels related to risperidone treatment. The aim of this systematic review and meta-analysis was to investigate whether DRD2 polymorphisms could modulate prolactin levels in patients treated with risperidone. METHODS Three electronic databases (PubMed, EMBASE and the Cochrane Library) were searched for studies investigating the effect of DRD2 polymorphisms on prolactin levels in patients treated with risperidone until May 2018. Summary standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated with Hedges' g tests for effect estimates using random effects models. The heterogeneity, sensitivity, univariable meta-regression, subgroup analyses and publication biases were calculated. RESULTS AND DISCUSSION After initially identifying 886 studies, 772 patients from eight studies were included. Summary SMDs indicated that compared with A1 non-carriers, Taq1A A1 carriers did not have different risperidone-related prolactin levels (SMD: 0.13; 95% CI: -0.18 to 0.43; P = 0.423) among patients with schizophrenia (SCZ; SMD: 0.07; 95% CI: -0.14 to 0.29; P = 0.505) or among those without SCZ (SMD: 0.16; 95% CI: -0.39 to 0.71; P = 0.562). There was no significant difference between Del carriers and Del non-carriers with regard to risperidone-related prolactin levels (SMD: -0.00; 95% CI: -0.59 to 0.58; P = 0.996). In an Asian subgroup analysis, we also noted that compared with Taq1A A1A2 carriers, Taq1A A1A1 carriers had lower prolactin levels (SMD: -0.34; 95% CI: -0.66 to -0.02; P = 0.040). However, there was no significant difference in prolactin levels between A1A1 carriers and A2A2 carriers (SMD: -0.27; 95% CI: -0.60 to 0.05; P = 0.098), or between A2 carriers and A2 non-carriers (SMD: 0.29; 95% CI: -0.01 to 0.59; P = 0.059). Based on univariable meta-regression analyses, the effects of publication year, study design, ethnicity, comparison groups and study quality could bias the identified association of DRD2 Taq1A with risperidone-related prolactin levels. WHAT IS NEW AND CONCLUSION The findings of this study suggest that there is no significant difference between Taq1A A1 carriers and non-A1 carriers with regard to risperidone-related prolactin levels. As there were few A1 homozygotes, large prospective studies with robust designs are still needed to investigate whether A1A1 could affect risperidone-related prolactin levels in the Asian population.
Collapse
Affiliation(s)
- Lingyue Ma
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Qian Xiang
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Shuang Zhou
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Yunlong Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Xiaodan Zhang
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Ting Yang
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Qiufen Xie
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Guangyan Mu
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Xia Zhao
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Ying Zhou
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Suxia Li
- National Institute on Drug Dependence, Peking University Sixth Hospital/Institute of Mental Health and Key Laboratory of Mental Health, Peking University, Beijing, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| |
Collapse
|
6
|
Alladi CG, Mohan A, Shewade DG, Rajkumar RP, Adithan S, Subramanian K. Risperidone-Induced Adverse Drug Reactions and Role of DRD2 (-141 C Ins/Del) and 5HTR2C (-759 C>T) Genetic Polymorphisms in Patients with Schizophrenia. J Pharmacol Pharmacother 2017; 8:28-32. [PMID: 28405133 PMCID: PMC5370325 DOI: 10.4103/jpp.jpp_197_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To determine the adverse drug reaction (ADR) profile of risperidone and their association with dopamine (DRD2 - 141 C Ins/Del/rs1799732) and serotonin receptor (5HTR2C -759 C>T/rs3813929) gene polymorphisms in patients with schizophrenia. MATERIALS AND METHODS The study was conducted among 289 patients who were diagnosed with schizophrenia and were on treatment with risperidone (4-8 mg/day)-based therapy for a minimum of 4 weeks. Genotyping was carried by real-time quantitative polymerase chain reaction. All the patients were observed for the occurrences of ADRs during the study. Changes in prolactin levels and body weight were analyzed for a subgroup of 102 and 97 patients, respectively. RESULTS Risperidone-induced extrapyramidal symptoms (EPSs) were seen in 36.7% of patients. Among them, tremors were the most common symptom 31.8%. Risperidone-induced hyperprolactinemia and weight gain were seen in 87.2% and 53.6% in subgroup patients. Adverse effects such as sedation, gastrointestinal effects, and amenorrhea were seen in 9.7% (28/289), 5.1% (15/289), and 6.1% (7/114), respectively. Occurrence of DRD2 - 141 Ins/Del and Del/Del polymorphisms were significantly associated with increased prolactin levels in response to risperidone (odds ratio [OR] = 10.45; 95% confidence interval = 1.29-84.89, P = 0.004). No such association was observed with 5HTR2C (-759 C>T) polymorphism. Weight gain and EPS were not associated with the above genetic polymorphisms. CONCLUSION Hyperprolactinemia, weight gain, and EPSs (>36.7%) were common adverse effects of risperidone. DRD2 - 141C Ins/Del and Del/Del polymorphisms were significantly associated with increased prolactin levels (OR = 10.45) in response to risperidone.
Collapse
Affiliation(s)
- Charanraj Goud Alladi
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Anbarasan Mohan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Deepak Gopal Shewade
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Surendiran Adithan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Karthick Subramanian
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
7
|
Han J, Li Y, Wang X. Potential link between genetic polymorphisms of catechol-O-methyltransferase and dopamine receptors and treatment efficacy of risperidone on schizophrenia. Neuropsychiatr Dis Treat 2017; 13:2935-2943. [PMID: 29255361 PMCID: PMC5722007 DOI: 10.2147/ndt.s148824] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The current study aimed to explore the association of single nucleotide polymorphisms (SNPs) within catechol-O-methyltransferase (COMT) and dopamine receptors with schizophrenia and genetic association with risperidone treatment response. METHODS A total of 690 schizophrenic patients (case group) were selected and 430 healthy people were included as the controls. All patients received risperidone treatment continuously for 8 weeks. Next, peripheral venous blood samples were collected and were subjected to polymerase chain reaction-restriction fragment length polymorphism to amplify and genotype the SNPs within COMT and dopamine receptors. Then, correlation analysis was conducted between Positive and Negative Syndrome Scale improvement rates and SNPs within COMT and the dopamine receptor gene. RESULTS The allele of DRD1 rs11749676 (A) emerged as a key element in reducing schizophrenia risk with statistical significance (P<0.001). Remarkably, alleles of COMT rs165774 (G), DRD2 rs6277 (T), and DRD3 rs6280 (C) were associated with raised predisposition to schizophrenia (all P<0.001). Regarding DRD1 rs11746641, DRD1 rs11749676, DRD2 rs6277, and DRD3 rs6280, the case group exhibited a lesser frequency of heterozygotes in comparison with wild homozygotes genotype (all P<0.001). SNPs (COMT rs4680, DRD2 rs6275, DRD2 rs1801028, and DRD2 rs6277) were remarkably associated with improvement rates of PANSS total scores (P<0.05). SNPs (COMT rs165599 and DRD2 rs1801028) were significantly associated with risperidone efficacy on negative symptoms (P<0.05). CONCLUSION COMT SNPs and dopamine receptor SNPs were correlated with prevalence of schizophrenia and risperidone treatment efficacy of schizophrenia.
Collapse
Affiliation(s)
- Jiyang Han
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan Li
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Xumei Wang
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
8
|
Miura I, Zhang JP, Hagi K, Lencz T, Kane JM, Yabe H, Malhotra AK, Correll CU. Variants in the DRD2 locus and antipsychotic-related prolactin levels: A meta-analysis. Psychoneuroendocrinology 2016; 72:1-10. [PMID: 27333159 PMCID: PMC10443951 DOI: 10.1016/j.psyneuen.2016.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 06/03/2016] [Accepted: 06/03/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Although dopamine D2 receptor antagonists lead to dose-dependent prolactin (PRL) elevations proportionate to their D2 affinity, considerable inter-individual differences exist. We conducted a meta-analytic review of associations between genetic variations in the dopamine D2 receptor gene (DRD2) and PRL levels in antipsychotic-treated subjects. METHODS Systematic literature search (5/8/2015) was performed to find published studies of pharmacogenetic associations between two DRD2 variants, Taq1A (rs1800497) and -141C Ins/Del (rs1799732), and PRL levels during antipsychotic treatment (excluding aripiprazole). Patients were included independent of age or diagnosis. Random effects models were used and Hedges' g was calculated as the effect size measure. Subgroup analyses explored the effect of sex and diagnosis, (males vs females; schizophrenia vs non-schizophrenia). RESULTS Altogether, 11 studies (n=1034, schizophrenia-spectrum=475) for Taq1A polymorphism, and 4 studies (n=451, schizophrenia-spectrum=274) for -141C Ins/Del polymorphism, each reporting on PRL levels but not on the proportion of patients with hyperprolactinemia, were meta-analyzed. Across all patients, there was no statistically significant association between PRL levels and either DRD2 Taq1A genotype or DRD2 -141C Ins/Del genotype. However, in patients with schizophrenia, PRL levels were significantly higher in DRD2 Taq1A A1 carriers than A1 non-carriers (studies=5, n=475, Hedges' g=0.250, 95% CI=0.068-0.433, p=0.007, I(2)=0%). DISCUSSION Although there was no significant association between either DRD2 Taq1A genotype or DRD2 -141C Ins/Del genotype and PRL levels in all included patients, our results suggest that DRD2 Taq1A genotype may affect antipsychotic-related PRL levels in patients with schizophrenia. Because of the small sample size, further studies are needed to confirm these results.
Collapse
Affiliation(s)
- Itaru Miura
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Jian-Ping Zhang
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Katsuhiko Hagi
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Sumitomo Dainippon Pharma Co., Ltd., Medical Affairs, Tokyo, Japan
| | - Todd Lencz
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA
| | - John M Kane
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Anil K Malhotra
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christoph U Correll
- The Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA; Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA.
| |
Collapse
|
9
|
Pharmacokinetic patterns of risperidone-associated adverse drug reactions. Eur J Clin Pharmacol 2016; 72:1091-8. [DOI: 10.1007/s00228-016-2085-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/20/2016] [Indexed: 01/03/2023]
|
10
|
Charan A, Shewade DG, Rajkumar RP, Chandrasekaran A. Relation between serum prolactin levels and antipsychotic response to risperidone in patients with schizophrenia. Psychiatry Res 2016; 240:209-213. [PMID: 27111215 DOI: 10.1016/j.psychres.2016.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/10/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hyperprolactinemia is commonly seen in patients with schizophrenia on risperidone. Dopamine receptor blockade plays a major role in risperidone induced hyperprolactinemia. However, limited studies are available with inconsistent results on antipsychotic response to risperidone and prolactin elevation. Therefore, we aimed to study the change in serum prolactin levels and response to risperidone and to test the association between DRD2 genetic variants and prolactin levels in schizophrenic patients treated with risperidone. METHODS A prospective study comprising of 102 patients with schizophrenia were recruited. Prolactin levels and Positive and Negative Syndrome Scale (PANSS) score were recorded at baseline and after four weeks of risperidone treatment. Prolactin concentrations were measured by standard method Advia-Centaur® Chemiluminescence immuno assay method. Taq1A DRD2 genotyping was performed by qRT-PCR. RESULTS The mean±SD prolactin levels (ng/ml) were increased after four weeks of treatment in both responders (males 21.66±15.15 to 41.63±18.73; p<0.01 females 51.92±40.89 to 122.35±52.16; p<0.01) and non-responders group (males 23.89±14.85 to 37.45±13.5; p<0.01 females 39.25±26.94 to 91.13±54.31; p<0.01). Patients with increased prolactin concentration were 4.6 fold higher in responders (OR 4.60; 95%CI 1.376-15.389; p-value 0.01) compared to non-responders. Ninety-six patients were genotyped for Taq1A DRD2 gene (AA=9, AG=46, GG=41) and found no association (p=0.6) between genetic variants and response to risperidone. CONCLUSION Patients were showing more than 20% increase in prolactin levels had a better chance of responding to risperidone therapy. Taq1A DRD2 gene did not show any association with prolactin elevation and response to risperidone.
Collapse
Affiliation(s)
- Alladi Charan
- Department of Pharmacology, JIPMER, Puducherry 605006, India.
| | | | | | | |
Collapse
|
11
|
Impact of Pharmacogenetic Markers of CYP2D6 and DRD2 on Prolactin Response in Risperidone-Treated Thai Children and Adolescents With Autism Spectrum Disorders. J Clin Psychopharmacol 2016; 36:141-6. [PMID: 26872113 DOI: 10.1097/jcp.0000000000000474] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of the study was to identify the impact of pharmacogenetic markers associated with prolactin concentration in risperidone-treated children and adolescents with autism spectrum disorders. METHODS One hundred forty-seven children and adolescents with autism, aged 3 to 19 years, received risperidone. The clinical data of patients were recorded from medical records. Prolactin levels were measured by chemiluminescence immunoassay. Three CYP2D6 single nucleotide polymorphisms, CYP2D6*4 (1846G>A), *10 (100C>T), and *41 (2988G>A), 1 gene deletion (*5), and DRD2 Taq1A (rs1800497) polymorphism were genotyped by TaqMan real-time polymerase chain reaction. RESULTS The 3 common allelic frequencies were CYP2D6*10 (55.10%), *1 (32.65%), and *5 (6.12%), respectively. Patients were grouped according to their CYP2D6 genotypes. There was no significant correlation between the concentrations of prolactin among the CYP2D6 genotypes. In addition, there were no statistical differences in the prolactin response among the CYP2D6-predicted phenotypes of extensive metabolizer and intermediate metabolizer. The DRD2 genotype frequencies were Taq1A A2A2 (38.77%), A1A2 (41.50%), and A1A1 (19.73%), respectively. There were statistically significant differences in prolactin level of patients among the 3 groups (P = 0.033). The median prolactin level in patients with DRD2 Taq1A A2A2 (17.80 ng/mL) was significantly higher than A1A2 (17.10 ng/mL) and A1A1 (12.70 ng/mL). CONCLUSIONS DRD2 Taq1A A2A2 polymorphisms may play a significant role in the hyperprolactinemia- associated with risperidone treatment in children and adolescent with autism spectrum disorder. Many drugs used chronically in psychiatric diseases exert their effects mainly through the dopamine D2 receptor. It is therefore possible that these drugs could alter the expression of any dopamine receptor, thus affecting the pharmacodynamics characteristics and toxicity of drug substrates during pharmacotherapy.
Collapse
|
12
|
Ngamsamut N, Hongkaew Y, Vanwong N, Srisawasdi P, Puangpetch A, Chamkrachangpada B, Tan-Khum T, Limsila P, Sukasem C. 9-Hydroxyrisperidone-Induced Hyperprolactinaemia in Thai Children and Adolescents with Autism Spectrum Disorder. Basic Clin Pharmacol Toxicol 2016; 119:267-72. [DOI: 10.1111/bcpt.12570] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/12/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Nattawat Ngamsamut
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital; Department of Mental Health Services; Ministry of Public Health; Samut Prakan Thailand
| | - Yaowaluck Hongkaew
- Division of Pharmacogenomics and Personalized Medicine; Department of Pathology; Faculty of Medicine Ramathibodi Hospital; Mahidol University; Bangkok Thailand
- Laboratory for Pharmacogenomics; Somdech Phra Debaratana Medical Center (SDMC); Ramathibodi Hospital; Bangkok Thailand
| | - Natchaya Vanwong
- Division of Pharmacogenomics and Personalized Medicine; Department of Pathology; Faculty of Medicine Ramathibodi Hospital; Mahidol University; Bangkok Thailand
- Laboratory for Pharmacogenomics; Somdech Phra Debaratana Medical Center (SDMC); Ramathibodi Hospital; Bangkok Thailand
| | - Pornpen Srisawasdi
- Division of Clinical Chemistry; Department of Pathology; Faculty of Medicine; Ramathibodi Hospital; Mahidol University; Bangkok Thailand
| | - Apichaya Puangpetch
- Division of Pharmacogenomics and Personalized Medicine; Department of Pathology; Faculty of Medicine Ramathibodi Hospital; Mahidol University; Bangkok Thailand
- Laboratory for Pharmacogenomics; Somdech Phra Debaratana Medical Center (SDMC); Ramathibodi Hospital; Bangkok Thailand
| | - Bhunnada Chamkrachangpada
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital; Department of Mental Health Services; Ministry of Public Health; Samut Prakan Thailand
| | - Theerarat Tan-Khum
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital; Department of Mental Health Services; Ministry of Public Health; Samut Prakan Thailand
| | - Penkhae Limsila
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital; Department of Mental Health Services; Ministry of Public Health; Samut Prakan Thailand
| | - Chonlaphat Sukasem
- Division of Pharmacogenomics and Personalized Medicine; Department of Pathology; Faculty of Medicine Ramathibodi Hospital; Mahidol University; Bangkok Thailand
- Laboratory for Pharmacogenomics; Somdech Phra Debaratana Medical Center (SDMC); Ramathibodi Hospital; Bangkok Thailand
| |
Collapse
|
13
|
Chen CY, Yeh YW, Kuo SC, Ho PS, Liang CS, Yen CH, Lu RB, Huang SY. Catechol-O-methyltransferase gene variants may associate with negative symptom response and plasma concentrations of prolactin in schizophrenia after amisulpride treatment. Psychoneuroendocrinology 2016; 65:67-75. [PMID: 26724569 DOI: 10.1016/j.psyneuen.2015.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 12/01/2015] [Accepted: 12/04/2015] [Indexed: 01/04/2023]
Abstract
Catechol-O-methyltransferase (COMT) enzyme is involved in the pathogenesis of psychotic symptoms and may be associated with a therapeutic response to antipsychotic drugs. The aim of this study was to examine the relationship between COMT variants, plasma prolactin level, and the therapeutic effectiveness of amisulpride treatment in patients with schizophrenia. A 12-week naturalistic study of amisulpride treatment was carried out in 185 Han Chinese patients with schizophrenia. The patients were screened for 14 single-nucleotide polymorphisms of the COMT gene. The Positive and Negative Syndrome Scale (PANSS) was used to assess the improvement of psychopathological symptoms from the baseline to the end point in each subject. For better presentation of time-course changes in response status, a mixed model for repeated-measures (MMRM) analysis of symptom improvement during the 12-week treatment period was conducted. The change in plasma prolactin level after amisulpride treatment was also examined (n=51). No significant differences in the genotype frequencies of the COMT variants investigated were observed between responders and non-responders. Moreover, an MMRM analysis of psychopathological symptom improvement during the 12-week treatment course showed that it depended significantly on COMT variants (rs4680, rs4633, and rs6267), particularly regarding changes in negative symptoms. The increase in plasma prolactin levels observed was influenced by the COMT rs4680 variant and was positively correlated with a reduction in PANSS negative scores. Our results suggest that variation of the COMT gene is associated with treatment response regarding negative symptoms and prolactin changes after amisulpride treatment in patients with schizophrenia.
Collapse
Affiliation(s)
- Chun-Yen Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Wei Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shin-Chang Kuo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Shen Ho
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sung Liang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Hung Yen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - San-Yuan Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| |
Collapse
|
14
|
dos Santos Júnior A, Henriques TB, de Mello MP, Ferreira Neto AP, Paes LA, Della Torre OH, Sewaybricker LE, Fontana TS, Celeri EHRV, Guerra Júnior G, Dalgalarrondo P. Hyperprolactinemia in Children and Adolescents with Use of Risperidone: Clinical and Molecular Genetics Aspects. J Child Adolesc Psychopharmacol 2015; 25:738-48. [PMID: 26682995 DOI: 10.1089/cap.2015.0094] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In children and adolescents treated with risperidone, hyperprolactinemia is a frequent complication that may have clinical repercussions. Several genes have been associated with this occurrence. The aim of this study was to evaluate the frequency of hyperprolactinemia in children and adolescents treated with risperidone, and its associations with clinical and pharmacological data and certain polymorphisms of the following genes: Dopamine receptor D2 (DRD2), 5-hydroxytryptamine (serotonin) receptor 2C (HTR2C), cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6), leptin (LEP), leptin receptor (LEPR), melanocortin 4 receptor (MC4R), and scavenger receptor class B, member 2 (SCARB2). METHODS The study included patients using risperidone (8-20 years old) and healthy subjects not exposed to the medication. Psychopathological symptoms, doses, and duration of treatment with risperidone, sex, skin color, body mass index (BMI), use of other psychotropic drugs, and polymorphisms of DRD2, HTR2C, CYP2D6, LEP, LEPR, MC4R, and SCARB2 genes were evaluated. RESULTS There were 120 patients and 197 individuals not exposed to risperidone who were evaluated. Among patients, hyperprolactinemia was found in 79 (65.8%) cases, with no differences regarding sex, skin color, or being in monotherapy with risperidone (26.7% of total patients) or not. The level of prolactin was not correlated, either in case or control groups, with chronological age, bone age, prescribed dose of risperidone, weight-adjusted dose of risperidone, or BMI (p > 0.05), but was negatively correlated with the treatment duration (r = -0.352, p = 0.001 among cases; and r = -0.324, p = 0.039 among controls). There were significant differences in use of risperidone between patients and healthy subjects without the medication in the frequency of the polymorphisms of the DRD2, HTR2C, and LEP genes. Considering both sexes together and also specifically among females, the occurrence of hyperprolactinemia was higher in the presence of the C allele of the rs6318 single nucleotide polymorphisms (SNP) of the HTR2C gene. CONCLUSIONS This group of children and adolescents with or without isolated use of risperidone presented with a high frequency of hyperprolactinemia, although asymptomatic, and associated, when considering only females or both sexes together, with being a carrier of the C allele of the rs6318 SNP of the HTR2C gene.
Collapse
Affiliation(s)
- Amilton dos Santos Júnior
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| | - Taciane Barbosa Henriques
- 2 Laboratory of Human Genetics, Center for Molecular Biology and Genetic Engineering (CBMEG) , Unicamp, Campinas, SP, Brazil
| | - Maricilda Palandi de Mello
- 2 Laboratory of Human Genetics, Center for Molecular Biology and Genetic Engineering (CBMEG) , Unicamp, Campinas, SP, Brazil
| | - Adriana Perez Ferreira Neto
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| | - Lúcia Arisaka Paes
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| | - Osmar Henrique Della Torre
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| | - Letícia Esposito Sewaybricker
- 3 Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED) , FCM, Unicamp, Campinas, SP, Brazil
| | - Thiago Salum Fontana
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| | | | - Gil Guerra Júnior
- 3 Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED) , FCM, Unicamp, Campinas, SP, Brazil .,4 Department of Pediatrics, Pediatric Endocrinology Unit , FCM, Unicamp, Campinas, SP, Brazil
| | - Paulo Dalgalarrondo
- 1 Department of Psychiatry, School of Medical Sciences (FCM), State University of Campinas (Unicamp) , Campinas, SP, Brazil
| |
Collapse
|
15
|
Ilhan M, Kahraman OT, Turan S, Turgut S, Karaman O, Zeybek U, Shukurov S, Yaylim I, Tasan E. Does DRD2 polymorphism influence the clinical characteristics of prolactinoma? ANNALES D'ENDOCRINOLOGIE 2015; 76:614-9. [PMID: 26514951 DOI: 10.1016/j.ando.2015.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/28/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Genetic alterations explaining the clinical variability of prolactinomas still could not be clarified and dopamine D2 receptor (DRD2) polymorphism is a putative candidate for the variable response to dopaminergic treatment. The present study was conducted to investigate the influence of DRD2 TaqI A polymorphism on initial and follow-up characteristics of prolactinoma. PATIENTS AND METHODS Seventy-two patients with prolactinoma and 98 age and gender matched control subjects were recruited to the case-control study. Serum prolactin levels were assessed by enzyme-linked immunosorbent assay and DRD2 polymorphism was determined by polymerase chain reaction and restriction length polymorphism analysis. RESULTS Decrease of prolactin levels and the tumor shrinkage after cabergoline treatment were 93.9±5.9% and 58.3±33.1% in microadenomas and 96.1±6.1% and 51.7±29.3 in macroadenomas (P=0.02 and P>0.05, respectively). We observed no significant difference for DRD2 genotypes and the alleles between the patients and healthy group (P>0.05). Prolactin levels before treatment were correlated with tumor diameter before and after treatment and the percentage of prolactin decrease with treatment (P<0.001 r=0.58, P<0.001 r=0.40 and P<0.001 r=0.47, respectively). Tumor diameter before the treatment was also correlated with the tumor diameter after the treatment (P<0.001 r=0.64) and the percentage of prolactin decrease (P=0.01 r=0.30). However, no significant association was found between characteristics of prolactinoma and DRD2 genotypes and alleles (P>0.05). CONCLUSION This study revealed that DRD2 TaqI A receptor polymorphism was not associated with the development of prolactinoma and its clinical characteristics. Future studies are needed to clarify the clinical implications of genetic alterations in prolactinoma.
Collapse
Affiliation(s)
- Muzaffer Ilhan
- Bezmialem University, Department of Endocrinology and Metabolism, Vatan Caddesi, 34093 Istanbul, Turkey.
| | - Ozlem Timirci Kahraman
- The Institute of Experimental Medicine, Department of Molecular Medicine, Millet Caddesi, Capa, Istanbul University, Istanbul, Turkey
| | - Saime Turan
- The Institute of Experimental Medicine, Department of Molecular Medicine, Millet Caddesi, Capa, Istanbul University, Istanbul, Turkey
| | - Seda Turgut
- Bezmialem University, Internal Medicine Department, Vatan Caddesi, 34093 Istanbul, Turkey
| | - Ozcan Karaman
- Bezmialem University, Department of Endocrinology and Metabolism, Vatan Caddesi, 34093 Istanbul, Turkey
| | - Umit Zeybek
- The Institute of Experimental Medicine, Department of Molecular Medicine, Millet Caddesi, Capa, Istanbul University, Istanbul, Turkey
| | - Samir Shukurov
- Bezmialem University, Department of Endocrinology and Metabolism, Vatan Caddesi, 34093 Istanbul, Turkey
| | - Ilhan Yaylim
- The Institute of Experimental Medicine, Department of Molecular Medicine, Millet Caddesi, Capa, Istanbul University, Istanbul, Turkey
| | - Ertugrul Tasan
- Bezmialem University, Department of Endocrinology and Metabolism, Vatan Caddesi, 34093 Istanbul, Turkey
| |
Collapse
|
16
|
Hongkaew Y, Ngamsamut N, Puangpetch A, Vanwong N, Srisawasdi P, Chamnanphon M, Chamkrachchangpada B, Tan-Kam T, Limsila P, Sukasem C. Hyperprolactinemia in Thai children and adolescents with autism spectrum disorder treated with risperidone. Neuropsychiatr Dis Treat 2015; 11:191-6. [PMID: 25653528 PMCID: PMC4309788 DOI: 10.2147/ndt.s76276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD) during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females) aged 3-19 years with ASD received risperidone treatment (0.10-6.00 mg/day) for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records - age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern - were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90%) subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.30-29.20) of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.65-22.30) and low (11.70, IQR 7.51-16.50) doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with risperidone. This study suggests that risperidone treatment causes prolactin elevations and the effects of risperidone on prolactin are probably dose-related in pediatric patients.
Collapse
Affiliation(s)
- Yaowaluck Hongkaew
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nattawat Ngamsamut
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Bangkok, Thailand
| | - Apichaya Puangpetch
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Natchaya Vanwong
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pornpen Srisawasdi
- Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Montri Chamnanphon
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Bhunnada Chamkrachchangpada
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Bangkok, Thailand
| | - Teerarat Tan-Kam
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Bangkok, Thailand
| | - Penkhae Limsila
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Bangkok, Thailand
| | - Chonlaphat Sukasem
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Bangkok, Thailand ; Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
17
|
Peuskens J, Pani L, Detraux J, De Hert M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs 2014; 28:421-53. [PMID: 24677189 PMCID: PMC4022988 DOI: 10.1007/s40263-014-0157-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Since the 1970s, clinicians have increasingly become more familiar with hyperprolactinemia (HPRL) as a common adverse effect of antipsychotic medication, which remains the cornerstone of pharmacological treatment for patients with schizophrenia. Although treatment with second-generation antipsychotics (SGAs) as a group is, compared with use of the first-generation antipsychotics, associated with lower prolactin (PRL) plasma levels, the detailed effects on plasma PRL levels for each of these compounds in reports often remain incomplete or inaccurate. Moreover, at this moment, no review has been published about the effect of the newly approved antipsychotics asenapine, iloperidone and lurasidone on PRL levels. The objective of this review is to describe PRL physiology; PRL measurement; diagnosis, causes, consequences and mechanisms of HPRL; incidence figures of (new-onset) HPRL with SGAs and newly approved antipsychotics in adolescent and adult patients; and revisit lingering questions regarding this hormone. A literature search, using the MEDLINE database (1966-December 2013), was conducted to identify relevant publications to report on the state of the art of HPRL and to summarize the available evidence with respect to the propensity of the SGAs and the newly approved antipsychotics to elevate PRL levels. Our review shows that although HPRL usually is defined as a sustained level of PRL above the laboratory upper limit of normal, limit values show some degree of variability in clinical reports, making the interpretation and comparison of data across studies difficult. Moreover, many reports do not provide much or any data detailing the measurement of PRL. Although the highest rates of HPRL are consistently reported in association with amisulpride, risperidone and paliperidone, while aripiprazole and quetiapine have the most favorable profile with respect to this outcome, all SGAs can induce PRL elevations, especially at the beginning of treatment, and have the potential to cause new-onset HPRL. Considering the PRL-elevating propensity of the newly approved antipsychotics, evidence seems to indicate these agents have a PRL profile comparable to that of clozapine (asenapine and iloperidone), ziprasidone and olanzapine (lurasidone). PRL elevations with antipsychotic medication generally are dose dependant. However, antipsychotics having a high potential for PRL elevation (amisulpride, risperidone and paliperidone) can have a profound impact on PRL levels even at relatively low doses, while PRL levels with antipsychotics having a minimal effect on PRL, in most cases, can remain unchanged (quetiapine) or reduce (aripiprazole) over all dosages. Although tolerance and decreases in PRL values after long-term administration of PRL-elevating antipsychotics can occur, the elevations, in most cases, remain above the upper limit of normal. PRL profiles of antipsychotics in children and adolescents seem to be the same as in adults. The hyperprolactinemic effects of antipsychotic medication are mostly correlated with their affinity for dopamine D2 receptors at the level of the anterior pituitary lactotrophs (and probably other neurotransmitter mechanisms) and their blood-brain barrier penetrating capability. Even though antipsychotics are the most common cause of pharmacologically induced HPRL, recent research has shown that HPRL can be pre-existing in a substantial portion of antipsychotic-naïve patients with first-episode psychosis or at-risk mental state.
Collapse
Affiliation(s)
- J. Peuskens
- Department of Neurosciences, KU Leuven, University Psychiatric Centre, Catholic University Leuven, Kortenberg, Belgium
| | - L. Pani
- Italian Medicines Agency (AIFA), Rome, Italy
| | - J. Detraux
- Department of Neurosciences, KU Leuven, University Psychiatric Centre, Catholic University Leuven, Kortenberg, Belgium
| | - M. De Hert
- Department of Neurosciences, KU Leuven, University Psychiatric Centre, Catholic University Leuven, Kortenberg, Belgium
| |
Collapse
|
18
|
Godar SC, Bortolato M. Gene-sex interactions in schizophrenia: focus on dopamine neurotransmission. Front Behav Neurosci 2014; 8:71. [PMID: 24639636 PMCID: PMC3944784 DOI: 10.3389/fnbeh.2014.00071] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/19/2014] [Indexed: 02/02/2023] Open
Abstract
Schizophrenia is a severe mental disorder, with a highly complex and heterogenous clinical presentation. Our current perspectives posit that the pathogenic mechanisms of this illness lie in complex arrays of gene × environment interactions. Furthermore, several findings indicate that males have a higher susceptibility for schizophrenia, with earlier age of onset and overall poorer clinical prognosis. Based on these premises, several authors have recently begun exploring the possibility that the greater schizophrenia vulnerability in males may reflect specific gene × sex (G×S) interactions. Our knowledge on such G×S interactions in schizophrenia is still rudimentary; nevertheless, the bulk of preclinical evidence suggests that the molecular mechanisms for such interactions are likely contributed by the neurobiological effects of sex steroids on dopamine (DA) neurotransmission. Accordingly, several recent studies suggest a gender-specific association of certain DAergic genes with schizophrenia. These G×S interactions have been particularly documented for catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO), the main enzymes catalyzing DA metabolism. In the present review, we will outline the current evidence on the interactions of DA-related genes and sex-related factors, and discuss the potential molecular substrates that may mediate their cooperative actions in schizophrenia pathogenesis.
Collapse
Affiliation(s)
- Sean C Godar
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas Lawrence, KS, USA
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas Lawrence, KS, USA ; Consortium for Translational Research on Aggression and Drug Abuse, University of Kansas Lawrence, KS, USA
| |
Collapse
|
19
|
Tashiro M, Naito T, Ohnishi K, Kagawa Y, Kawakami J. Impact of genetic and non-genetic factors on clinical responses to prochlorperazine in oxycodone-treated cancer patients. Clin Chim Acta 2014; 429:175-80. [DOI: 10.1016/j.cca.2013.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/11/2013] [Accepted: 12/10/2013] [Indexed: 11/30/2022]
|
20
|
The effect of the Taq1A variant in the dopamine D2 receptor gene and common CYP2D6 alleles on prolactin levels in risperidone-treated boys. Pharmacogenet Genomics 2013; 23:487-93. [DOI: 10.1097/fpc.0b013e3283647c33] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
21
|
Tian J, Wang W, Ye L, Cen X, Guan X, Zhang J, Yu P, Du G, Liu W, Li Y. A 12-week intramuscular toxicity study of risperidone-loaded microspheres in Beagle dogs. Hum Exp Toxicol 2013; 33:473-87. [DOI: 10.1177/0960327113499045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Long-acting formulations of antipsychotics are important treatment options to increase the compliance of schizophrenic patients. Risperidone, a 5-HT2 and dopaminergic D2 receptor antagonist, was developed as long-acting sustained-release microspheres with poly(lactide-co-glycolide) (PLGA) as a drug carrier for the treatment of schizophrenia. In the present study, the main objective is to determine the nonclinical safety profile of risperidone-loaded microspheres (RM) in Beagle dogs after intramuscular administration for 3 months, once in 2 weeks, followed by 8-week recovery phase. No animal death was found and no special toxicological findings were observed. The findings, such as hypoactivity, ptosis, increased heart rate, and elevated serum and pituitary prolactin levels, were observed and related to the pharmacological effects of risperidone. The changes in the reproductive system (uterus, ovary, vagina, cervix, and mammary gland) were considered secondary to the prolactin elevation, and the congestion of spleen was related to risperidone. The foreign body granulomas at injection sites might be caused by PLGA. At the end of recovery phase, the above changes mostly recovered to normal, and on administering 3 mg/kg dose level once in 2 weeks on Beagle dogs showed no observed adverse effect. Taken together, RM had exhibited the acceptable safety.
Collapse
Affiliation(s)
- J Tian
- School of Pharmacy, Yantai University, Yantai, Shandong, People's Republic of China
| | - W Wang
- School of Pharmacy, Yantai University, Yantai, Shandong, People's Republic of China
| | - L Ye
- Research & Development Center, Luye Pharma Group Ltd., Yantai, Shandong, People's Republic of China
| | - X Cen
- WestChina-Frontier PharmaTech Co. (WCFP) and National Chengdu Center for Safety Evaluation of Drugs (NCCSED), Chengdu, Sichuan, People’s Republic of China
| | - X Guan
- WestChina-Frontier PharmaTech Co. (WCFP) and National Chengdu Center for Safety Evaluation of Drugs (NCCSED), Chengdu, Sichuan, People’s Republic of China
| | - J Zhang
- Research & Development Center, Luye Pharma Group Ltd., Yantai, Shandong, People's Republic of China
| | - P Yu
- Research & Development Center, Luye Pharma Group Ltd., Yantai, Shandong, People's Republic of China
| | - G Du
- School of Pharmacy, Yantai University, Yantai, Shandong, People's Republic of China
| | - W Liu
- School of Pharmacy, Yantai University, Yantai, Shandong, People's Republic of China
| | - Y Li
- Research & Development Center, Luye Pharma Group Ltd., Yantai, Shandong, People's Republic of China
| |
Collapse
|
22
|
López-Rodríguez R, Cabaleiro T, Ochoa D, Román M, Borobia AM, Carcas AJ, Ayuso C, Novalbos J, Abad-Santos F. Pharmacodynamic genetic variants related to antipsychotic adverse reactions in healthy volunteers. Pharmacogenomics 2013; 14:1203-14. [DOI: 10.2217/pgs.13.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: Clinical trials with healthy volunteers are a useful model for evaluating safety and tolerability, without the interference of concomitant diseases and drugs. The present study aims to improve our understanding of antipsychotic-related adverse reactions (ARs) and their possible association with common genetic variants of pharmacodynamic proteins such as neurotransmitter receptors/transporters. Materials & methods: A total of eight polymorphisms located in seven pharmacodynamic-related genes (SCL6A4, MDR1, 5HT2A, DRD2, DRD3, COMT and GRIN2B) were genotyped in a cohort of 211 healthy volunteers who received a single dose of risperidone (1 mg), olanzapine (5 mg) or quetiapine (25 mg). Results: Interestingly, a significant association was found between the incidence of neurological ARs and specific polymorphisms in key genes (DRD2 and SCL6A4). Conclusion: Genetic variants in pharmacodynamic genes could represent valuable markers of AR risk and antipsychotic safety. Original submitted 7 February 2013; Revision submitted 3 June 2013
Collapse
Affiliation(s)
- Rosario López-Rodríguez
- Liver Unit, Gastroenterology Service, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Diego de Leon 62, 3ª, 28006 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Cabaleiro
- Service of Clinical Pharmacology, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Dolores Ochoa
- Service of Clinical Pharmacology, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Manuel Román
- Service of Clinical Pharmacology, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Alberto M Borobia
- Service of Clinical Pharmacology, Hospital Universitario La Paz, Pharmacology Department, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antonio J Carcas
- Service of Clinical Pharmacology, Hospital Universitario La Paz, Pharmacology Department, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carmen Ayuso
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria Fundacion Jimenez Diaz, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Novalbos
- Service of Clinical Pharmacology, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Francisco Abad-Santos
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Service of Clinical Pharmacology, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| |
Collapse
|
23
|
Gao S, Hu Z, Cheng J, Zhou W, Xu Y, Xie S, Liu S, Li Z, Guo J, Dong J, Huang M. Impact of catechol-o-methyltransferase polymorphisms on risperidone treatment for schizophrenia and its potential clinical significance. Clin Biochem 2012; 45:787-92. [PMID: 22560999 DOI: 10.1016/j.clinbiochem.2012.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 03/27/2012] [Accepted: 04/19/2012] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The main aim was to study the effects of COMT polymorphisms on response of risperidone treatment for schizophrenia and investigate the correlation between memory function of schizophrenia patients and COMT polymorphisms. DESIGN AND METHODS Subjects were 83 schizophrenic patients who were antipsychotic drug free at the initiation of this study. Peripheral blood samples were obtained to identify COMT polymorphisms by using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Clinical Global Impressions (CGI), Positive and Negative Syndrome Scale (PANSS) and Wechsler Memory Scale (WMS) test were used to assess the effect of risperidone treatment. RESULTS The Val/Met carriers showed a significant increase in change of P300 during treatment (P=0.032). Association of Val/Met carriers performed better than other genotypes (P=0.028). The mean plasma concentration of prolactin of Val/Val carriers was significantly lower (P=0.017). CONCLUSIONS The COMT polymorphisms may be a potential biomarker for clinical risperidone treatment in schizophrenia.
Collapse
Affiliation(s)
- Shugui Gao
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Hill LD, Ewens KG, Maher BS, York TP, Legro RS, Dunaif A, Strauss JF. Catechol-O-methyltransferase (COMT) single nucleotide polymorphisms and haplotypes are not major risk factors for polycystic ovary syndrome. Mol Cell Endocrinol 2012; 350:72-7. [PMID: 22178088 PMCID: PMC3264817 DOI: 10.1016/j.mce.2011.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/17/2011] [Accepted: 11/18/2011] [Indexed: 10/14/2022]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 5-8% of reproductive age women. The primary features of PCOS are hyperandrogenemia, chronic anovulation and infertility. It has been suggested that defects in ovarian steroid metabolism contribute to the follicular growth arrest and abnormal production of ovarian steroid hormones that are characteristic of PCOS. 2-Methoxyestradiol (2-ME) is formed by the action of catechol-O-methyltransferase (COMT) on 2-hydroxyestradiol. COMT expression is increased in the follicles and ovarian stroma of women with PCOS. Moreover, 2-ME decreases granulosa cell proliferation and steroidogenesis, raising the possibility that ovarian dysfunction associated with PCOS is due, in part, to increased synthesis of 2-ME resulting from increased COMT activity. Four single-nucleotide polymorphisms (SNPs) (rs6269, rs4633, rs4818, rs4680) in the COMT gene characterize haplotypes, which are associated with large variations in COMT enzymatic activity. The aim of this study was to determine whether individual COMT SNPs and the COMT haplotypes are associated with PCOS using a family-based test of association and linkage. Additionally, we examined the relationships between COMT SNPs and haplotypes with quantitative variables usually assessed in the evaluation of women with PCOS. There were no significant correlations between genotype and total testosterone, non-SHBG bound testosterone and BMI. However, we found that the prolactin level in women with PCOS varied significantly with COMT haplotype, and suggest that this association reflects a genetic factor influencing the stress response. Our findings suggest that common variants and haplotypes of the COMT gene are not major contributors to risk for PCOS, but that COMT genotype may influence prolactin levels.
Collapse
Affiliation(s)
- Lori D Hill
- Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
| | | | | | | | | | | | | |
Collapse
|
25
|
DRD2 Taq1A polymorphism modulates prolactin secretion induced by atypical antipsychotics in healthy volunteers. J Clin Psychopharmacol 2011; 31:555-62. [PMID: 21869700 DOI: 10.1097/jcp.0b013e31822cfff2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hyperprolactinemia mediated by antagonism of dopaminergic neurotransmission in the pituitary gland is a common adverse effect of antipsychotics. Recent studies have suggested that polymorphisms of dopamine receptors can affect the therapeutic response to antipsychotics. Thus, our aim was to evaluate whether 2 such polymorphisms (DRD2 Taq1A and DRD3 Ser9Gly) modulate prolactin release in healthy volunteers (n = 119) receiving a single dose of quetiapine (25 mg, n = 26), olanzapine (5 mg, n = 57), or risperidone (1 mg, n = 36). The increases in maximum concentration and in area under the curve were calculated from plasma prolactin levels after subtraction of pretreatment levels. Multiple regression analyses revealed that prolactin increases in maximum concentration and in area under the curve depended on drug (quetiapine < olanzapine < risperidone; P < 0.001), sex (women > men; P < 0.001), and Taq1A polymorphism (A1⁺ > A2/A2; P < 0.05). Analysis of the individual drugs revealed that prolactin secretion was modulated by sex and Taq1A polymorphism in olanzapine and risperidone (P < 0.05); however, these factors were not linked to prolactin secretion in quetiapine.
Collapse
|
26
|
Houston J, Dharia S, Bishop JR, Ellingrod VL, Fijal B, Jacobson JG, Hoffmann VP. Association of DRD2 and ANKK1 polymorphisms with prolactin increase in olanzapine-treated women. Psychiatry Res 2011; 187:74-9. [PMID: 21095016 DOI: 10.1016/j.psychres.2010.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 10/18/2010] [Accepted: 10/24/2010] [Indexed: 10/18/2022]
Abstract
UNLABELLED Dopamine D2 receptors, encoded by DRD2, play a role in regulating serum prolactin concentration. Single nucleotide polymorphisms (SNPs), rs2734842(C), rs6275(T), and rs6279(C) located within DRD2, have been shown to be associated with prolactin increase in olanzapine/fluoxetine combination (OFC)-treated women. The present analyses seek to replicate these results and test other SNPs in DRD2 and neighboring gene ANKK1 for associations with prolactin increase in women, using data from 3 pooled studies of olanzapine, and 2 previously examined studies OFC. An ANCOVA was used to test whether change from baseline in the natural log of prolactin concentration (ln[prolactin]) was associated with SNPs in the pooled olanzapine studies. A meta-analysis was also performed using the inverse chi-square method, pooling p-values from the 2 previously examined studies and the 3 olanzapine studies. Negative strand alleles rs2734842(C), rs6275(T), and rs6279(C) were significantly associated with increased prolactin in olanzapine-treated women, replicating previous results. These SNPs also showed moderate association with increased prolactin in olanzapine-treated and OFC-treated women in the meta-analysis, as did rs4938016, rs2734848, rs2734841, rs1124493, and rs1076562. Five of these SNPs fall in or are adjacent to an LD block spanning DRD2 intron 7, exon 7, 5' untranslated region and ANKK1. CLINICAL TRIAL REGISTRATION www.clinicaltrial.gov.
Collapse
|
27
|
Ohta C, Yasui-Furukori N, Furukori H, Tsuchimine S, Saito M, Nakagami T, Yoshizawa K, Kaneko S. The effect of smoking status on the plasma concentration of prolactin already elevated by risperidone treatment in schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:573-6. [PMID: 21216266 DOI: 10.1016/j.pnpbp.2010.12.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Revised: 12/25/2010] [Accepted: 12/25/2010] [Indexed: 11/29/2022]
Abstract
Smoking prevalence for schizophrenic patients is higher than for the general population. Inter-individual variability in hyperprolactinemia induced antipsychotics particularly risperidone can be explained by smoking status to some extent. We therefore studied the effects of smoking status on the plasma concentration of prolactin. Subjects included 154 schizophrenia patients (61 males, 93 females) who had received 3 mg of risperidone twice daily for at least 4 weeks. Sample collections were conducted 12 h after the bedtime dosing. The plasma concentrations of prolactin in the females were significantly higher than in the males (117.6±69.3 ng/ml vs. 52.9±30.7 ng/ml, p<0.001). The mean (±SD) plasma concentrations of prolactin did not differ between smokers and nonsmokers in the males (59.5±31.2 ng/ml vs. 47.6±29.3 ng/ml, not significant (ns)), but there was a significant difference in the females (100.2±59.1 vs. 134.0±74.6, ng/ml, p<0.05). Multiple regression analyses including gender, plasma drug concentration and age revealed that the plasma concentration of prolactin positively correlated with gender (standardized beta=0.452, p<0.001) and negatively with age (standardized beta=-0.171, p<0.05) and smoking status (standardized beta=-0.232, p<0.01). These findings suggest that smoking status has an impact on prolactin concentration during risperidone treatment. However, further study is required to determine whether these findings have clinical implications.
Collapse
Affiliation(s)
- Chikako Ohta
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Yasui-Furukori N, Saito M, Nakagami T, Sugawara N, Sato Y, Tsuchimine S, Furukori H, Kaneko S. Gender-specific prolactin response to antipsychotic treatments with risperidone and olanzapine and its relationship to drug concentrations in patients with acutely exacerbated schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:537-40. [PMID: 20170699 DOI: 10.1016/j.pnpbp.2010.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 01/26/2010] [Accepted: 02/11/2010] [Indexed: 10/19/2022]
Abstract
Hyperprolactinemia is a frequent consequence of treatment with antipsychotic agents, partially because the prolactin response to antipsychotics is related to dopamine blockade. Recent studies have suggested that the prolactin response to olanzapine is weaker than that to risperidone. Thus, we studied the effects of various factors on the elevated plasma prolactin levels caused by these medications. The subjects were 94 patients with acutely exacerbated schizophrenia (46 males, 48 females). For four weeks, they received 6mg of risperidone and 20mg of olanzapine daily. Plasma samples were collected before the medications were given and 12h after the bedtime dosing each week. Treatment with either risperidone or olanzapine boosted plasma prolactin levels above baseline in both males and females. Prolactin levels were significantly higher in females than in males at all sampling points in both treatments. Risperidone increased prolactin significantly more than did olanzapine in both males and females. Delta prolactin (prolactin level at four weeks minus the baseline prolactin level) during olanzapine treatment significantly correlated with olanzapine concentration at 4th week (r=-0.518, p<0.01) only in males. Multiple regression analyses showed that delta prolactin during risperidone was significantly correlated with gender (p<0.001) and age (p<0.05) and that delta prolactin during olanzapine significantly correlated with gender (p<0.001) and drug concentration (p<0.01). The present study suggests that the predominant factors influencing hyperprolactinemia are young female for risperidone treatment, and being female and lower drug concentration as a predictor for hyperprolactinemia under olanzapine.
Collapse
Affiliation(s)
- Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Yasui-Furukori N, Furukori H, Sugawara N, Tsuchimine S, Fujii A, Inoue Y, Kaneko S. Prolactin fluctuation over the course of a day during treatments with three atypical antipsychotics in schizophrenic patients. Hum Psychopharmacol 2010; 25:236-42. [PMID: 20373475 DOI: 10.1002/hup.1110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hyperprolactinemia is a frequent consequence of treatment with some antipsychotic agents. Although prolactin secretion varies over the course of a day and during psychological circumstances, there is little information in the literature regarding the time dependence of the prolactin response to antipsychotics. We evaluated prolactin levels in schizophrenic patients receiving risperidone (3 mg twice daily), olanzapine (10 mg twice daily), or perospirone (16 mg twice daily) for at least 4 weeks. The subjects were compared to matched healthy controls. Plasma sample collection for quantification of drug and prolactin levels was conducted before and 2, 4, 6, 8, and 12 h after the morning dosing. Prolactin concentrations before dosing during risperidone treatment were significantly higher than during treatment with olanzapine and perospirone in females. The daily fluctuation of prolactin concentration after perospirone treatment was larger than that observed after risperidone and olanzapine treatments. Areas under the plasma concentration-time curves was greatest in subjects treated with risperidone, followed by perospirone and finally by olanzapine. These findings suggest that daily fluctuations in prolactin concentration after perospirone treatment are larger than following treatment with risperidone and olanzapine. The plasma concentration of prolactin during perospirone treatment therefore depends on the time of sampling.
Collapse
Affiliation(s)
- Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan.
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
Currently available antipsychotic drugs (APDs) carry significant, though highly variable, liability to neurologic and metabolic side effects. Pharmacogenetics approaches offer the possibility of identifying patient-specific biomarkers for predicting risk of these side effects. To date, a few single nucleotide polymorphisms (SNPs) in a handful of genes have received convergent support across multiple studies. The primary focus has been on SNPs in dopamine and serotonin receptor genes: persuasive meta-analytic evidence exists for an effect of the dopamine D2 and D3 receptor genes (DRD2 and DRD3) in risk for tardr inesia (TD) and for an effect of variation at the receptor gene (HTR2C) for liability to APD-inducec gain. However, effect sizes appear to be modest, and pharmacoeconomic considerations have not been sufficiently studied, thereby limiting clinical applicability at this time. Effects of these genes and others on risk for TD, extrapyramidal side effects, hyperprolactinemia, and weight gain are revieved in this article.
Collapse
Affiliation(s)
- Todd Lencz
- Center for Translational Psychiatry, Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
| | | |
Collapse
|
31
|
Filopanti M, Lania AG, Spada A. Pharmacogenetics of D2 dopamine receptor gene in prolactin-secreting pituitary adenomas. Expert Opin Drug Metab Toxicol 2010; 6:43-53. [PMID: 19929252 DOI: 10.1517/17425250903352501] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Dopamine-agonists are the treatment of choice of prolactin-secreting pituitary adenomas (PRL-omas). Their actions on D2 dopamine receptor (DRD2) and the clinical outcome may be affected by polymorphisms. AREAS COVERED IN THIS REVIEW PRL-omas are well-differentiated endocrine tumors expressing DRD2. The dopamine-agonist cabergoline (CB), normalizes prolactin and reduces tumor size in about 80 - 90% of patients. DRD2 polymorphisms correlate with neuropsychiatric disorders, in particular alcoholism and schizophrenia. This review describes the DRD2 polymorphisms, their functional effects, and their impact on susceptibility and response to dopamine-agonists treatment. Searching PubMed database for pertinent articles we found that some DRD2 polymorphisms, particularly TaqIA, TaqIB and NcoI, are associated with different receptor binding in brain areas. One study carried out in patients with PRL-omas found a correlation between NcoI and TaqIA and resistance to CB. In particular, resistant patients had higher prevalence of NcoI-T allele than the responsive patients, while the commonest haplotype (having TaqIA2 allele) was associated with better response. WHAT THE READER WILL GAIN This review deals with the connection between DRD2 polymorphisms and PRL-oma treatment and suggests hypotheses for further studies. TAKE HOME MESSAGE Only one study was carried out to analyze the role of DRD2 polymorphisms in PRLomas response to CB. Further studies, including pituitary and hypothalamus in vivo determination of DRD2 binding according to DRD2 genotypes, investigation of possible post-receptorial mechanisms involved, as well as population studies in collaboration with psychiatrists and neurologists, are needed.
Collapse
Affiliation(s)
- M Filopanti
- Fondazione IRCCS Policlinico Mangiagalli Regina Elena, Unit of Endocrinology and Diabetology, Milan, Italy
| | | | | |
Collapse
|
32
|
Correia CT, Almeida JP, Santos PE, Sequeira AF, Marques CE, Miguel TS, Abreu RL, Oliveira GG, Vicente AM. Pharmacogenetics of risperidone therapy in autism: association analysis of eight candidate genes with drug efficacy and adverse drug reactions. THE PHARMACOGENOMICS JOURNAL 2009; 10:418-30. [PMID: 19997080 DOI: 10.1038/tpj.2009.63] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Little has been reported on the factors, genetic or other, that underlie the variability in individual response, particularly for autism. In this study we simultaneously explored the effects of multiple candidate genes on clinical improvement and occurrence of adverse drug reactions, in 45 autistic patients who received monotherapy with risperidone up to 1 year. Candidate genes involved in the pharmacokinetics (CYP2D6 and ABCB1) and pharmacodynamics (HTR2A, HTR2C, DRD2, DRD3, HTR6) of the drug, and the brain-derived neurotrophic factor (BDNF) gene, were analysed. Using the generalized estimating equation method these genes were tested for association with drug efficacy, assessed with the Autism Treatment Evaluation Checklist, and with safety and tolerability measures, such as prolactin levels, body mass index (BMI), waist circumference and neurological adverse effects, including extrapyramidal movements. Our results confirm that risperidone therapy was very effective in reducing some autism symptoms and caused few serious adverse effects. After adjusting for confounding factors, the HTR2A c.-1438G>A, DRD3 Ser9Gly, HTR2C c.995G>A and ABCB1 1236C>T polymorphisms were predictors for clinical improvement with risperidone therapy. The HTR2A c.-1438G>A, HTR2C c.68G>C (p.C33S), HTR6 c.7154-2542C>T and BDNF c.196G>A (p.V66M) polymorphisms influenced prolactin elevation. HTR2C c.68G>C and CYP2D6 polymorphisms were associated with risperidone-induced increase in BMI or waist circumference. We thus identified for the first time several genes implicated in risperidone efficacy and safety in autism patients. Although association results require replication, given the small sample size, the study makes a preliminary contribution to the personalized therapy of risperidone in autism.
Collapse
Affiliation(s)
- C T Correia
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Calarge CA, Ellingrod VL, Acion L, Miller DD, Moline J, Tansey MJ, Schlechte JA. Variants of the dopamine D2 receptor gene and risperidone-induced hyperprolactinemia in children and adolescents. Pharmacogenet Genomics 2009; 19:373-82. [PMID: 19339912 PMCID: PMC2699901 DOI: 10.1097/fpc.0b013e328329a60f] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the association between hyperprolactinemia and variants of the dopamine D2 receptor (DRD2) gene in children and adolescents in long-term treatment with risperidone. METHODS Medically healthy 7 to 17-year-old patients chronically treated with risperidone but receiving no other antipsychotics were recruited in a cross-sectional study. Four DRD2 variants were genotyped and prolactin concentration was measured. Medication history was obtained from the medical records. The effect of the TaqIA variants of the DRD2 on the risk of risperidone-induced hyperprolactinemia was the primary outcome measure. RESULTS Hyperprolactinemia was present in 50% of 107 patients (87% males) treated with risperidone for an average of 2.9 years. Age, stage of sexual development, and the dose of risperidone independently predicted a higher prolactin concentration, whereas the dose of psychostimulants was negatively correlated with it. However, these four predictors became nonsignificant when risperidone serum concentration was entered into the model. Adverse events potentially related to hyperprolactinemia were more common in participants with elevated prolactin concentration and in girls (45%) compared with boys (10%). After controlling for risperidone concentration and the dose of psychostimulants, the TaqIA A1 and the A-241G alleles were associated with higher prolactin concentration, whereas the -141C Ins/Del and C957T variants had no significant effect. In addition, adverse events potentially related to hyperprolactinemia were four times more common in TaqIA A1 allele carriers. CONCLUSION Prolactin concentration is closely related to central DRD2 blockade, as reflected by risperidone serum concentration. Furthermore, the TaqIA and A-241G variants of the DRD2 gene could be useful in predicting the emergence of hyperprolactinemia and its potential adverse events.
Collapse
Affiliation(s)
- Chadi A Calarge
- The University of Iowa Carver College of Medicine, Iowa, USA.
| | | | | | | | | | | | | |
Collapse
|