Pharmacogenomics in psychiatric practice: Latin America initiatives

Abstract

Pharmacogenomics has had a good development in most of medical specialties, nevertheless in psychiatry has been particularly successful. Accordingly, it has been extremely useful in psychiatric patients considering how common is the use of therapeutic regimens that combine several drugs with significant interactions between them. Patients with complex pathologies such as bipolar affective disorder, major depression, psychotic depression, borderline personality disorder, organic brain damage with uncontrolled impulses, among others, have medical advice that is necessary to obtain their genotype profile. In some of these patients, the genotyping results may involve to withdraw some drugs, decrease doses, avoid certain combinations of drugs, or continue using high doses or complex combination therapies with greater confidence. In this respect, CYP2D6 is a biotransformation enzyme particularly relevant in psychiatric drugs metabolism. Therefore, characterization of its variants in Latin American population is extremely important considering that only some few studies in the region have revealed ethnic differences. Pharmacogenomics appears to be the main tool in psychiatry to select the right medicine and suitable dose for each patient.