Influence of CYP2D6 phenotype on adherence, adverse effects, and attitudes in aripiprazole and risperidone users.

IF 2.6 4区医学 Q3 NEUROSCIENCES

Acta Neuropsychiatrica Pub Date : 2025-03-25 DOI:10.1017/neu.2025.11

Elina Hietala, Anssi Solismaa, Markku Lähteenvuo, Ari V Ahola-Olli, Katja Häkkinen, Kimmo Suokas, Erkki Isometsä, Jaana Suvisaari, Tuula Kieseppä, Minna Holm, Jari Tiihonen, Jouko Lönnqvist, Jarmo Hietala, Asko Wegelius, Kaisla Lahdensuo, Willehard Haaki, Olli Kampman

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引用次数: 0

Abstract

Background: Non-adherence and negative attitudes towards medication are major problems in treating psychotic disorders. Cytochrome P450 2D6 (CYP2D6) contributes to the metabolism of aripiprazole and risperidone. Variations in CYP2D6 activity may affect treatment response or adverse effects. The impact of these variations on adherence and medication attitudes is unclear.

Aims: This study investigates the relationships between CYP2D6 phenotype, self-reported adherence, adverse effects, and attitudes among aripiprazole and risperidone users.

Methods: This study analyzed data from the SUPER-Finland cohort of 10,474 adults with psychotic episodes, including 1,429 aripiprazole and 828 risperidone users. The Attitudes towards neuroleptic treatment (ANT) questionnaire assessed adherence and adverse effects in all patients, while medication-related attitudes were examined in a subgroup of 1,000 participants. Associations between CYP2D6 phenotypes and outcomes were analyzed using logistic regression and beta regression in aripiprazole and risperidone groups separately.

Results: Among risperidone users, we observed no association between CYP2D6 phenotypes and adherence, adverse effects, or attitudes. Similarly, no link was found between adherence and CYP2D6 phenotypes among aripiprazole users. However, aripiprazole users with the ultrarapid CYP2D6 phenotype had more adverse effects (OR = 1.71, 95 % CI 1.03-2.90, p = 0.041). Among aripiprazole users, CYP2D6 ultrarapid phenotype was associated with less favorable attitudes towards antipsychotic treatment (β = -0.48, p = 0.023).

Conclusions: We found preliminary evidence that the ultrarapid CYP2D6 phenotype is associated with increased adverse effects and negative attitudes towards antipsychotic medication among aripiprazole users. CYP2D6 phenotype did not influence adherence, adverse effects, or attitudes among risperidone users.

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背景：不坚持服药和对药物的消极态度是治疗精神病的主要问题。细胞色素 P450 2D6 (CYP2D6) 参与阿立哌唑和利培酮的代谢。CYP2D6 活性的变化可能会影响治疗反应或不良反应。目的：本研究调查了阿立哌唑和利培酮使用者的 CYP2D6 表型、自我报告的依从性、不良反应和态度之间的关系：本研究分析了芬兰 SUPER 队列中 10,474 名精神病发作成人的数据，其中包括 1,429 名阿立哌唑使用者和 828 名利培酮使用者。神经安定剂治疗态度（ANT）问卷对所有患者的依从性和不良反应进行了评估，同时对1000名参与者组成的子组进行了药物相关态度的调查。在阿立哌唑组和利培酮组分别使用逻辑回归和贝塔回归分析了CYP2D6表型与结果之间的关联：在利培酮使用者中，我们没有观察到 CYP2D6 表型与依从性、不良反应或态度之间的关系。同样，在阿立哌唑使用者中也没有发现依从性与 CYP2D6 表型之间的联系。然而，具有超快速CYP2D6表型的阿立哌唑使用者的不良反应较多（OR = 1.71，95 % CI 1.03-2.90，p = 0.041）。在阿立哌唑使用者中，CYP2D6超快速表型与较差的抗精神病治疗态度相关（β = -0.48，p = 0.023）：我们发现有初步证据表明，CYP2D6超快速表型与阿立哌唑使用者不良反应增加和对抗抑郁药物的负面态度有关。CYP2D6表型对利培酮使用者的依从性、不良反应或态度没有影响。

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来源期刊

Acta Neuropsychiatrica NEUROSCIENCES-PSYCHIATRY

自引率

5.30%

发文量

期刊介绍： Acta Neuropsychiatrica is an international journal focussing on translational neuropsychiatry. It publishes high-quality original research papers and reviews. The Journal''s scope specifically highlights the pathway from discovery to clinical applications, healthcare and global health that can be viewed broadly as the spectrum of work that marks the pathway from discovery to global health.