Pharmacogenetic tests for antipsychotic medications: clinical implications and considerations

Figures & data

TABLE I. Common pharmacokinetic gene variants included in clinical testing panels for antipsychotic therapy. *Designation for allele; CYP, cytochrome P450; EM, extensive metabolizer; NM, normal metabolizer; IM, intermediate metabolizer; PM, poor metabolizer; UM, ultrarapid metabolizer

TABLE II. Drug metabolism pathways, labeling, and guideline information, and drug exposure (AUC) implications of pharmacogenetic information in antipsychotic medications. Bold font, major metabolism pathway; *Recommendation is based on haloperidol plasma levels studies.^4,17Percent Change in AUC: AUC in PM - AUC in EM/AUC in EM*100 AUC, area under the concentration-time curve; CPIC, Clinical Pharmacogenetics Implementation Consortium; DPWG, Royal Dutch Association for the Advancement of Pharmacy-Pharmacogenetics Working Group; EM, extensive metabolizer; FDA, US Food and Drug Administration; N/A, not available; NS, nonsignificant; PGx, pharmacogenetic; PK, pharmacokinetic; PM, poor metabolizer

Figure 1 Pharmacokinetic effects of CYP2D6 metabolizer phenotypes on elimination half-life.^{8-10 15,16} light blue, extensive metabolizer; dark blue, poor metabolizer

TABLE III. Common pharmacodynamic gene variants included in clinical testing panels for antipsychotic treatment response. 1000 genomes superpopulations are as follows: African (AFR; n=661), Mixed American (AMR; n=347), East Asian (EAS; n=504), European (EUR; n=503), and South Asian (SAS; n=489). Association data for each variant is summarized from the most recently published meta-analysis. US, upstream

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