This page was translated automatically from Turkish. Read the original

Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun.

SO149

Pharmacogenetic implementation plan for patients treated with depot antipsychotics

PHARMACOGENETIC IMPLEMENTATION PLAN IN PATIENTS TREATED WITH DEPOT ANTIPSYCHOTICS

Pharmacogenetic testing and therapeutic drug monitoring were successfully integrated into routine psychiatric care in a program involving 540 patients receiving long-acting injectable antipsychotics; 45% of patients had a non-normal CYP2D6 metabolizer phenotype.

The study aimed to design and implement a pharmacogenetic (PGx) and pharmacokinetic testing program for patients receiving long-acting injectable (LAI) antipsychotics in the Galician Health Service. Between 2021 and October 2025, 540 patients were enrolled in the program; PGx testing and/or therapeutic drug monitoring (TDM) were requested according to predefined clinical indications, and the results were integrated into the electronic health record (IANUS). Genotyping was performed using real-time PCR with a panel covering CYP2D6, CYP3A4, and ABCB1, including CYP2D6 copy number variation, while plasma levels of aripiprazole, dehydroaripiprazole, risperidone, and paliperidone were measured using a validated UHPLC-MS/MS method. A non-normal CYP2D6 metabolizer phenotype was identified in 45% of patients: normal metabolizers accounted for 55.0%, intermediate metabolizers for 34.4%, poor metabolizers for 6.3%, and ultrarapid metabolizers for 4.3%. CYP3A4 *20/*22 variants were absent in 93.3% of patients, while ABCB1 T allele variants were detected in 10.5%. Most of the 333 patients with concomitant medication data were taking 1 to 6 medications (median 4); potential CYP2D6-mediated drug–gene interactions were identified in 8% of normal metabolizers, primarily due to fluoxetine. TDM comprised 350 measurements in 343 patients; the proportions below, within, and above the target range were 14.4%, 62.6%, and 21.6% for paliperidone; 19.5%, 51.7%, and 27.6% for risperidone; and 21.0%, 66.9%, and 8.9% for aripiprazole. Program effectiveness indicators were reported as clinical follow-up in 54.6%, switching from oral treatment to an LAI in 38.5%, and suspected adverse drug reactions in 6.9%. The results show that PGx and TDM can feasibly be integrated into routine psychiatric care through structured workflows, trained staff, and electronic health record integration; the next step is to prospectively evaluate PGx- and TDM-guided treatment and clinical outcomes.

Tüm WCP 2026 özetleri