Clinical significance of pharmacogenomic studies in tardive dyskinesia associated with patients with psychiatric disorders

Figures & data

Table 1 Effect of cytochrome enzyme metabolism state on serum antipsychotic level and its association with tardive dyskinesia

Cytochrome enzyme	Antipsychotic	Serum antipsychotic level PM compared to EM	Serum antipsychotic level UM compared to EM	Metabolizer group associated with TD
CYP2D6	Aripiprazole	60% higher serum level^Citation46, 1.6 fold increase in active metabolite^Citation46,Citation47		NSD
	Clozapine	No difference^Citation47,Citation156^–^Citation158	No difference^Citation157,Citation158	NSD
	Haloperidol	Increased serum haloperidol and metabolite levels^Citation38^–^Citation42,Citation44,Citation45,Citation159		No association with TD^Citation44
	Risperidone	Increased serum risperidone^Citation42,Citation48		No association with TD^Citation58,Citation59
	Zuclopenthixol	1.6–2 fold increased serum level^Citation49^–^Citation52		Conflicting results. PM associated with TD in one study,^Citation51 another found no association with TD^Citation58,Citation59
	Perphenazine	2.9–4 fold increased serum level^Citation54,Citation160		No association with TD^Citation58,Citation59
	Thioridazine	1.8–4.5 fold increased serum level^Citation55^–^Citation57		NSD
	Olanzapine	No difference^Citation161		No association with TD^Citation58,Citation59
CYP1A2	Olanzapine	No difference^Citation161		No association with TD^Citation58,Citation59
CYP3A4	Thioridazine	1.8–4.5 fold increase serum level^Citation55^–^Citation57		NSD
	Aripiprazole	1.5–1.8 fold increase in serum level, 1.6 fold increase in active metabolite^Citation46		NSD
	Ziprasidone	NSD		NSD
	Olanzapine	NSD	Subtherapeutic serum olanzapine level^Citation162	NSD

Abbreviations: PM, poor metabolizer; EM, extensive metabolizer; UM, ultrafast metabolizer; TD, tardive dyskinesia; NSD, no studies done.

Table 2 Ethnicity and cytochrome enzyme metabolic action

Ethnicity	CYP2D6		CYP3A4		CYP1A2
	PM	UM	PM	UM	PM	UM
Caucasian	8%^Citation33,Citation34	1%–10%^Citation163	2%–9.6%^Citation164	14%^Citation162	NSD	NSD
African	3%–8%^Citation33,Citation34	2%–29%^Citation165	26%–67%^Citation164	67%^Citation162	NSD	NSD
Asian	6%–10%^Citation33,Citation34	0%–2%	0%–22%^Citation164	NSD	5%^Citation166	NSD
Japanese	0.39%^Citation35	NSD	NSD	NSD	14%^Citation166	NSD
Korean	0.22%^Citation36	NSD	NSD	NSD	NSD	NSD
Australian	NSD	NSD	NSD	NSD	5%^Citation7	NSD

Abbreviations: PM, poor metabolizers; UM, ultrafast metabolizers; NSD, no study done.

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