Molecular network-selected pharmacogenomics in a case of bipolar spectrum disorder. (December 2017)

• Record Type: Journal Article
• Authors: Fortinguerra, Stefano; Buriani, Alessandro; Sorrenti, Vincenzo; Lenzi, Michele; Giusti, Pietro
• Is Part Of: Pharmacogenomics. Volume 18:Number 18(2017)
• Page Start: 1631
• Page End: 1642
• Publication Date: 2017-12
• Subjects: antidepressants -- antipsychotics -- bipolar spectrum disorder -- monoaminergic transmission -- network pharmacology -- neurotransmitters -- personalized medicine -- psychiatry; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs-2017-0133
• Languages: English
• ISSNs: 1462-2416

Abstract

Personal genomic analysis was used for molecular diagnosis and pharmacogenomics in a 53-year-old female suffering from alternating depressive and dysphoric episodes. A total of 52 genes and 108 SNPs were analyzed in the whole genome. Results from the pharmacogenomic analysis were consistent with the pharmacological history and indicate mutations associated with low monoaminergic tone, but also a hyperactive 5HT2A receptor, a feature that associates to a high probability of developing a bipolar condition, especially under 5-hydroxytryptamine potentiating pharmacology. This aligns with the patient developing dysphoria with high clomipramine. The pharmacokinetic genomics pointed out to some absorption, distribution, metabolism, and excretion (ADME) alterations that can lower or nullify drug's activity. A personalized regimen was proposed, with a positive outcome after 1 year.