Correlation Between CYP2D6 Gene Polymorphism And Risperidone Adverse Reactions

Objectives:Analyzes the correlation between CYP2D6 gene polymorphism related to antipsychotic drugs and adverse drug reactions of risperidone in schizophrenia patients from the clinical use of risperidone.Methods:With the Real World Study method,selecte the daytime cases in the psychiatry department of Guangxi Liugang Hospital from June 1,2018 to February 30,2019,choice 30 patients taking risperidone alone who were observed and recorded in the actual state.We can use the PANSS scale of New patients(positive and negative syndrome scale)to assess their schizophrenia and give 2?6 mg/d routine dose treatment,take the CYP2D6 gene detection to each patient at the same time,according to the grouping of test results,the slow metabolism(PMs)and intermediate metabolism(IMs)patients will be gene mutation groups,normal metabolism(EMs)patients will be the normal metabolism groups.After 1 week,TESS scale(adverse reaction symptom scale)was used to evaluate the degree of adverse reactions of the two groups of patients,and assay the blood concentration,and then individualized drug regimen was given to the patients according to the results of gene test.The degree of adverse reactions was assessed by TESS at 2 and 4 weeks after the individualized prescription,and the efficacy of the two groups was assessed by PANSS scale and blood concentration at 4 weeks.We will evaluate the correlation between genotypes of the two groups and the incidence of adverse reactions by Statistical analysis.Results:13 patients with CYP2D6 gene mutation were tested from the 30 schizophrenics,and the remaining 17 patients with schizophrenia were all normal metabolic type,and the CYP2D6 gene mutateon rate was 43.3%.After 4 weeks of individualized administration,the drug dose(1.58 ± 0.6 mg/d)of patients in the mutant group was significantly lower than that in the normal metabolic group(4.3±0.8 mg/d),with statistical significance(P<0.05).During the same period,the total activesubstance dose-corrected concentration(32.84±20.07 ng/mL)in the mutant group was significantly higher than that in the normal group(9.72 ± 1.49 ng/mL),with statistical signifieance(P<0.05).After 4 weeks of individualized administration,the PANSS scale score of patients in the mutant group(42.95±10.72)was not statistically significant(P>0.05)compared with that in the normal group(43.94 ± 11.43),with no statistical significance(P>0.05).At 1 week of routine treatment dose after hospitalization,the incidence of adverse drug reactions in patients with mutation group(10/13)was significantly different from that in patients with normal metabolism group(2/17),with statistical significance(X2=13.03,P<0.05),the incidence of adverse reactions in the mutant group was higher than that in the normal metabolic group;and at the same period there was no statistically significant difference in the incidence of adverse drug reactions(1/13)between the mutant group and the normal metabolic group(2/17)after 4 weeks of individualized administration(X2=0.14,P>0.05).Conclusions:According to the results of CYP2D6 gene test,individualized drug administration for patients in the mutant group can achieve the goal of reducing the incidence of adverse reactions in this group.There is a significant correlation between CYP2D6 gene polymorphism and the incidence of adverse reactions to risperidone.The metabolic capacity of CYP2D6 enzyme on its substrate risperidone in the mutant group was significantly lower than that in the normal group,and the use of conventional treatment dose would lead to a higher incidence of adverse reactions in this group.Genetic testing for patients with schizophrenia and individualized drug administration based on the test results can reduce the incidence of adverse reactions and the economic burden of patients while maintaining the effective blood drug concentration and efficacy,and it is worth popularizing application in clinic.