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A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents

The second generation antipsychotic drug risperidone is widely used in the field of child and adolescent psychiatry to treat conditions associated with disruptive behavior, aggression and irritability, such as autism spectrum disorders. While risperidone can provide symptomatic relief for many patie...

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Autores principales: Dodsworth, Thomas, Kim, David D., Procyshyn, Ric M., Ross, Colin J., Honer, William G., Barr, Alasdair M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048722/
https://www.ncbi.nlm.nih.gov/pubmed/30026806
http://dx.doi.org/10.1186/s13034-018-0243-2
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author Dodsworth, Thomas
Kim, David D.
Procyshyn, Ric M.
Ross, Colin J.
Honer, William G.
Barr, Alasdair M.
author_facet Dodsworth, Thomas
Kim, David D.
Procyshyn, Ric M.
Ross, Colin J.
Honer, William G.
Barr, Alasdair M.
author_sort Dodsworth, Thomas
collection PubMed
description The second generation antipsychotic drug risperidone is widely used in the field of child and adolescent psychiatry to treat conditions associated with disruptive behavior, aggression and irritability, such as autism spectrum disorders. While risperidone can provide symptomatic relief for many patients, there is considerable individual variability in the therapeutic response and side-effect profile of the medication. One well established biological factor that contributes to these individual differences is genetic variation in the cytochrome P450 enzyme 2D6. The 2D6 enzyme metabolizes risperidone and therefore affects drug levels and dosing. In the present review, we summarize the current literature on 2D6 variants and their effects on risperidone responses, specifically in children and adolescents. Relevant articles were identified through systematic review, and after irrelevant articles were discarded, ten studies were included in the review. Most prospective studies were well controlled, but often did not have a large enough sample size to make robust statements about rarer variants, including those categorized as ultra-rapid and poor metabolizers. Individual studies demonstrated a role for different genetic variants in risperidone drug efficacy, pharmacokinetics, hyperprolactinemia, weight gain, extrapyramidal symptoms and drug–drug interactions. Where studies overlapped in measurements, there was typically a consensus between results. These findings indicate that the value of 2D6 genotyping in the youth population treated with risperidone requires further study, in particular with the less common variants.
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spelling pubmed-60487222018-07-19 A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents Dodsworth, Thomas Kim, David D. Procyshyn, Ric M. Ross, Colin J. Honer, William G. Barr, Alasdair M. Child Adolesc Psychiatry Ment Health Review The second generation antipsychotic drug risperidone is widely used in the field of child and adolescent psychiatry to treat conditions associated with disruptive behavior, aggression and irritability, such as autism spectrum disorders. While risperidone can provide symptomatic relief for many patients, there is considerable individual variability in the therapeutic response and side-effect profile of the medication. One well established biological factor that contributes to these individual differences is genetic variation in the cytochrome P450 enzyme 2D6. The 2D6 enzyme metabolizes risperidone and therefore affects drug levels and dosing. In the present review, we summarize the current literature on 2D6 variants and their effects on risperidone responses, specifically in children and adolescents. Relevant articles were identified through systematic review, and after irrelevant articles were discarded, ten studies were included in the review. Most prospective studies were well controlled, but often did not have a large enough sample size to make robust statements about rarer variants, including those categorized as ultra-rapid and poor metabolizers. Individual studies demonstrated a role for different genetic variants in risperidone drug efficacy, pharmacokinetics, hyperprolactinemia, weight gain, extrapyramidal symptoms and drug–drug interactions. Where studies overlapped in measurements, there was typically a consensus between results. These findings indicate that the value of 2D6 genotyping in the youth population treated with risperidone requires further study, in particular with the less common variants. BioMed Central 2018-07-16 /pmc/articles/PMC6048722/ /pubmed/30026806 http://dx.doi.org/10.1186/s13034-018-0243-2 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Dodsworth, Thomas
Kim, David D.
Procyshyn, Ric M.
Ross, Colin J.
Honer, William G.
Barr, Alasdair M.
A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title_full A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title_fullStr A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title_full_unstemmed A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title_short A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents
title_sort systematic review of the effects of cyp2d6 phenotypes on risperidone treatment in children and adolescents
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048722/
https://www.ncbi.nlm.nih.gov/pubmed/30026806
http://dx.doi.org/10.1186/s13034-018-0243-2
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