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Pharmacogenetics: a reality or misplaced optimism?

Authors


S. Mutsatsa, Faculty of Health and Social Care, London South Bank University, Gubbins Lane, Romford RM3 0BE, UK, E-mail: mutsatss@lsbu.ac.uk

Abstract

Accessible summary

  • • Evidence from research relating to the way genes affect medication effectiveness and side effects is reviewed.
  • • Currently, there is strong evidence suggesting that drug response varies across individuals and this is particularly so across racial and ethnic lines. These differences are genetically determined.
  • • There is hope that in future, an individual's genetic information can be used to help to decide which drug is effective for which person and at what dose before treatment.

Abstract

The paper aims to review current evidence that supports the application of genetic information in the management and use of psychotropic medication. Although the importance of an individual's genetic makeup in the metabolism of drugs has been known for at least 50 years, it is only recently that such information is finding clinical application. A literature review of recent studies suggest that there are clear variations in the way people respond to psychotropic medication. These variations can be seen across racial and ethnic lines, and are genetically determined. The hope is that, in future we will be able to use genetic information to predict which patient will benefit from which drug and at what dose. In other fields of health care such as anticoagulant therapy, the application of pharmacogenetics is now established in routine clinical care. Several psychiatric pharmacogenetic tests are currently available, including tests for the determination of metabolic status, risk of agranulocytosis and metabolic syndrome, and selection of beneficial medications. Since nurses are the centrepiece of mental health care, these advances are likely to alter significantly future mental health nurse education and practice.

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