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Advances in Psychiatric Treatment (2004) 10: 455-465
© 2004 The Royal College of Psychiatrists

Clinical relevance of discoveries in psychopharmacogenetics1

Evangelia M. Tsapakis, Amlan Basu and Katherine J. Aitchison

Evangelia M. Tsapakis is currently a research fellow at the Consolidated Department of Psychiatry (Neurosciences) at Harvard Medical School, having been awarded the 2003 Eli Lilly Travelling Fellowship by the Royal College of Psychiatrists (correspondence: Section of Clinical Neuropharmacology & MRC Social Genetic and Developmental Psychiatry Centre, Division of Psychological Medicine, PO 80, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: emtsapakis{at}doctors.org.uk). Amlan Basu is a senior house officer in psychiatry at the Maudsley Hospital and an honorary researcher at the Institute of Psychiatry. Katherine J. Aitchison is a clinical senior lecturer in adult psychiatry at the Institute of Psychiatry and an honorary consultant psychiatrist with the South London & Maudsley NHS Trust.

Individual genetic variation accounts for some of the variability in response to drugs used routinely in clinical psychiatry. Psychopharmacogenetics focuses on how polymorphisms in genes affecting the mechanism of action of a drug’s effect and/or metabolism (both peripheral and central) can influence an individual’s clinical response to the drug, in terms of both therapeutic efficacy and adverse effects. Pharmacogenetics promises to be of substantial help in the field of psychiatric pharmacotherapy, but before research findings can be applied to clinical practice, ethical and methodological problems have to be addressed and overcome. This review summarises the most robust findings in the field and outlines how psychopharmacogenetic studies could lead to treatment individualisation.




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