2021 AM Posters-Utility of Pharmacogenetic Analysis in Psychiatric Clinical

Utility of Pharmacogenetic Analysis in Psychiatric Clinical

Pdf Summary

Psychiatric readmissions have negative effects on patients, their families, and healthcare costs. There is a significant relationship between smoking and readmission for patients with psychiatric illnesses. Cigarette smoking increases the activity of enzymes that metabolize psychotropic medications. In this case report, the importance of considering a patient's smoking status in choosing antipsychotic medications is discussed, with guidance from psychotropic pharmacogenomics testing.<br /><br />The case involves a 28-year-old male with schizoaffective disorder who had multiple readmissions within a year. The patient experienced remission of psychotic symptoms prior to discharge but relapsed within 1-2 weeks after discharge. Various antipsychotic medications had been tried, but the patient failed to respond to them. Pharmacogenomics testing revealed that the patient metabolized certain enzymes rapidly and had reduced MTHFR enzyme activity.<br /><br />It was concluded that the previous antipsychotic medications were mainly metabolized by an enzyme that the patient was already a rapid metabolizer of. The patient resumed smoking after each discharge, inducing the activity of this enzyme even further and resulting in reduced levels of antipsychotics in the plasma and recurrence of psychotic symptoms. The decision was made to switch the patient to aripiprazole, which led to remission of psychotic symptoms, and the patient was also started on methylfolate, resulting in remission of depressive symptoms.<br /><br />This case highlights the importance of considering a patient's smoking status when selecting antipsychotic medications. It also demonstrates the utility of clinical pharmacogenomics studies in guiding the choice of psychotropic medications and reducing the costs of mental health care. Further research in this area could help optimize treatment outcomes and minimize readmissions for patients with psychiatric illnesses.

Keywords

psychiatric readmissions

negative effects

patients

families

healthcare costs

smoking

relationship

psychiatric illnesses

enzyme activity

antipsychotic medications

	The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.		400 Massasoit Avenue Suite 307 East Providence, RI 02914 cmecpd@aaap.org	About Advocacy Membership Fellowship Education and Resources Training Events