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Pharmacopsychiatry 2010; 43(5): 196-197
DOI: 10.1055/s-0030-1248315
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Familial Differential Treatment Response in Schizophrenia – Lessons From a Case of Three Affected Siblings

C. Hoyer1 , 2 , 3 , L. Kranaster1 , 2 , 3 , F. M. Leweke1 , 2 , J. Klosterkötter2 , A. Meyer-Lindenberg1 , D. Koethe2
  • 1Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
  • 2Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
  • 3These authors contributed equally to this work
Further Information

Publication History

received 29.06.2009 revised 09.12.2009

accepted 22.12.2009

Publication Date:
26 February 2010 (online)

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Introduction

We report the cases of three siblings (dizygotic twin sisters, one brother) with schizophrenia who showed an excellent response to the same antipsychotic drug, amisulpride, while other antipsychotic drugs were either ineffective or induced intolerable side effects. We discuss this case with respect to its implications for personalized treatment and stress the relevance of the antipsychotic drug history of affected relatives for choosing the most effective and suitable treatment option. We hypothesize that genetic proximity could contribute to a similar profile of response to currently used antipsychotic drugs.

References

  • 1 Adams DH, Close S, Farmen M. et al . Dopamine receptor D3 genotype association with greater acute positive symptom remission with olanzapine therapy in predominately caucasian patients with chronic schizophrenia or schizoaffective disorder.  Hum Psychopharmacol. 2008;  23 267-274
    CrossrefPubMedGoogle Scholar
  • 2 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders. DSM-IV. 4th edition.. Washington DC: American Psychiatric Association; 1994
    Google Scholar
  • 3 Andreasen NC, Carpenter Jr WT. Diagnosis and classification of schizophrenia.  Schizophrenia Bull. 1993;  19 199-214
    PubMedGoogle Scholar
  • 4 Carpenter Jr WT, Heinrichs DW, Wagman AM. Deficit and nondeficit forms of schizophrenia: the concept.  Am J Psychiatry. 1988;  145 578-583
    PubMedGoogle Scholar
  • 5 Chagnon YC, Merette C, Bouchard RH. et al . A genome wide linkage study of obesity as secondary effect of antipsychotics in multigenerational families of eastern Quebec affected by psychoses.  Mol Psychiatry. 2004;  9 1067-1074
    CrossrefPubMedGoogle Scholar
  • 6 de Leon J. The future (or lack of future) of personalized prescription in psychiatry.  Pharmacol Res. 2009;  59 81-89
    CrossrefPubMedGoogle Scholar
  • 7 Gupta M, Bhatnagar P, Grover S. et al . Association studies of catechol-O-methyltransferase (COMT) gene with schizophrenia and response to antipsychotic treatment.  Pharmacogenomics. 2009;  10 385-397
    CrossrefPubMedGoogle Scholar
  • 8 Guy W. Clinical global impression. In: ECDEU Assessment Manual for Psychopharmacology: National Insitute of Mental Health. 1976: 217-222
    PubMedGoogle Scholar
  • 9 Harrison PJ. Schizophrenia susceptibility genes and their neurodevelopmental implications: focus on neuregulin 1.  Novartis Found Symp. 2007;  288 246-255 discussion 255–249, 276–281
    PubMedGoogle Scholar
  • 10 Ikeda M, Yamanouchi Y, Kinoshita Y. et al . Variants of dopamine and serotonin candidate genes as predictors of response to risperidone treatment in first-episode schizophrenia.  Pharmacogenomics. 2008;  9 1437-1443
    CrossrefPubMedGoogle Scholar
  • 11 Inada T, Koga M, Ishiguro H. et al . Pathway-based association analysis of genome-wide screening data suggest that genes associated with the gamma-aminobutyric acid receptor signaling pathway are involved in neuroleptic-induced, treatment-resistant tardive dyskinesia.  Pharmacogenet Genomics. 2008;  18 317-323
    CrossrefPubMedGoogle Scholar
  • 12 Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia.  Schizophrenia Bull. 1987;  13 261-276
    CrossrefPubMedGoogle Scholar
  • 13 Lee HY, Kim DJ, Lee HJ. et al . No association of serotonin transporter polymorphism (5-HTTVNTR and 5-HTTLPR) with characteristics and treatment response to atypical antipsychotic agents in schizophrenic patients.  Prog Neuropsychopharmacol Biol Psychiatry. 2009;  33 276-280
    CrossrefPubMedGoogle Scholar
  • 14 Lencz T, Robinson DG, Xu K. et al . DRD2 promoter region variation as a predictor of sustained response to antipsychotic medication in first-episode schizophrenia patients.  Am J Psychiatry. 2006;  163 529-531
    CrossrefPubMedGoogle Scholar
  • 15 Malhotra AK, Lencz T, Correll CU, Kane JM. Genomics and the future of pharmacotherapy in psychiatry.  Int Rev Psychiatry. 2007;  19 523-530
    CrossrefPubMedGoogle Scholar
  • 16 McClay JL, Adkins DE, Aberg K. et al . Genome-wide pharmacogenomic analysis of response to treatment with antipsychotics.  Mol Psychiatry. 2009;  Sep 1 [Epub ahead of print]
    PubMedGoogle Scholar
  • 17 Murray RM, O’Callaghan E, Castle DJ. et al . A neurodevelopmental approach to the classification of schizophrenia.  Schizophrenia Bull. 1992;  18 319-332
    PubMedGoogle Scholar
  • 18 Need AC, Keefe RS, Ge D. et al . Pharmacogenetics of antipsychotic response in the CATIE trial: a candidate gene analysis.  Eur J Hum Genet. 2009;  17 946-957
    CrossrefPubMedGoogle Scholar
  • 19 van Os J, Burns T, Cavallaro R. et al . Standardized remission criteria in schizophrenia.  Acta Psychiatr Scand. 2006;  113 91-95
    CrossrefPubMedGoogle Scholar

Correspondence

C. HoyerMD, MPhil 

Department of Psychiatry and Psychotherapy

Central Institute of Mental Health

J5

68159 Mannheim

Germany

Phone: +49/621/1703 2331

Fax: +49/621/1703 2325

Email: hoyer@cimh.de

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