The Pharmacogenetics of Treatment with Quetiapine

Quetiapine is a second-generation antipsychotic used for the treatment of schizophrenia, depression and bipolar disorder. The aim of this traditional review was to summarize the available pharmacogenetic information on this drug and to conclude about its clinical relevance. For this purpose, bibliographic research was performed in the Pharmacogenomics Knowledge Base (PharmGKB) database. A total of 23 articles were initially retrieved, of which 15 were finally included. A total of 19 associations were observed between 15 genes, such as CYP3A4, CYP3A5, COMT or MC4R, and 29 clinical events. No associations were consistently replicated between pharmacogenetic biomarkers and clinical events, except for that between the CYP3A4 phenotype and quetiapine exposure, which was the only one considered clinically relevant. Consistently, the DPWG published a clinical guideline on this association, where dose adjustments for CYP3A4 poor metabolizers (PMs) are indicated to prevent the occurrence of adverse drug reactions (ADRs).