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Influence of the number of CYP2D6 active alleles on the antipsychotic daily doses, hospital duration and safety in psychiatric in-patients population

A.A. Kurylev1, 2, V.M. Brodyansky3, B.V. Andreev1, 4, A.O. Kibitov3
1 St. Petersburg State Budgetary Healthcare Institution “Psychiatric Hospital №1 named after P.P.Kashchenko”
2 «First Saint-Petersburg state medical university n.a. academician I.P. Pavlov» Ministry of health of Russia, Saint-Petersburg
3 « Federal Medical Research Centre of Psychiatry and Narcology of Ministry of Healthcare of the Russian Federation»
4 «Saint-Petersburg state university», Saint-Petersburg

Objective. To evaluate the influence of CYP2D6 genetic polymorphisms on mean antipsychotic daily dose, duration of hospital stay the and safety of antipsychotics in in-patients population.

Materials and methods. CYP2D6 genetic polymorphisms (*3, *4, *5, *6, *1ХN) were determined in 298 psychiatric in-patients. Antipsychotic drugs, EPS correctors, supporting therapy, doses, route of administration, hospital stay and EPS frequency were analyzed.

Results. Of 298 patient 4,4 % were identified as poor metabolizers, which corresponds to the frequency in Caucasian population. Lower mean antipsychotic daily doses in CPZ equivalents (p < 0,01), and define-daily dose (DDD) (p < 0,04) and higher EPS frequency (28 vs 72 %, p = 0,04) were observed in poor metabolizers group comparing to extensive metabolizers. The duration of hospital stay among poor and ultrarapid metabolizers was 16,21 (p < 0,01) days longer comparing to extensive metabolizers.

Conclusions. CYP2D6 poor matabolizers are characterized by lower antipsychotic daily doses and higher EPS frequency. Poor and ultarapid metabolizers have longer duration of hospital stay comparing to extensive metabolizers. The usage of typical or atypical antipsychotic does not influence mean daily dose across poor, extensive and ultrarapid metabolizers.

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