Utilizing plasma drug levels and genetic testing to achieve optimal treatment response in a patient with treatment-resistant schizoaffective disorder

被引：1
|
作者：
Xu, Jin-jie [1 ,2 ,3 ]
Xiao, Chunfeng [4 ]
Pan, Yanli [1 ,2 ,3 ]
Tang, Yi-lang [5 ,6 ]
Wang, Mingwan [1 ,2 ,3 ]
Li, Sheng [1 ,2 ,3 ]
Xie, Gaoming [1 ,2 ,3 ]
Du, Jing [1 ,2 ,3 ]
Ren, Yanping [1 ,2 ,3 ]
Wang, Wei [1 ,2 ,3 ]
机构：
[1] Capital Med Univ, Beijing Anding Hosp, Natl Clin Res Ctr Mental Disorders, Beijing Key Lab Mental Disorders, Beijing, Peoples R China
[2] Capital Med Univ, Beijing Anding Hosp, Natl Ctr Mental Disorders, Beijing, Peoples R China
[3] Capital Med Univ, Adv Innovat Ctr Human Brain Protect, Beijing, Peoples R China
[4] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Beijing, Peoples R China
[5] Emory Univ, Sch Med, Dept Psychiat & Behav Sci, Atlanta, GA USA
[6] Joseph Maxwell Cleland Atlanta VA Med Ctr, Mental Hlth Serv Line, Decatur, GA USA
来源：
BIPOLAR DISORDERS | 2024年 / 26卷 / 01期
关键词：
clozapine; pharmacogenomics; schizoaffective disorder; therapeutic drug monitoring; treatment-resistant; CLOZAPINE;
D O I：
10.1111/bdi.13385
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
We report the case of a Chinese male with schizoaffective disorder, an active smoker and a nonresponder to clozapine (600 mg daily). Therapeutic clozapine monitoring was analyzed, revealing a low concentration-dose ratio. A pharmacogenetic test showed that the patient had the CYP1A2*1F/*1F genotype, indicating an ultra-rapid clozapine metabolizer. In combination with fluvoxamine, a CYP1A2 enzyme inhibitor, clozapine plasma concentrations approached the reference range and achieved clinical improvement. This case demonstrates how pharmacogenetics can help understand the value of therapeutic drug monitoring to enhance the treatment of refractory schizoaffective disorder.
引用
收藏
页码：95 / 97
页数：3
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