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Tuesday, 4 January, 2000, 13:18 GMT
Tailor-made schizophrenia drugs on the way

Pipette Genetic research is making new treatments possible

Scienitists are moving closer to providing tailor-made individual treatment for people suffering from schizophrenia.

The technique - pharmacogenetics - could lead to individualised treatments for many other diseases.

Pharmacogentics is the study of the link between a patient's genetic make-up and their reaction to drugs or other foreign substances.

Doctors at the Institute of Psychiatry, Kings College, London have used the technique to find a way to predict which schizophrenic patients would be most likely to benefit from treatment with the antipsychotic drug clozapine.

Clozapine is one of a number of antipsychotic drugs available. It is a potent and expensive drug, but it is not effective for all patients.

Professor Robert Kerwin and Dr Maria Arranz told the millennium meeting of the British Pharmacological Society how they looked at 19 genetic variations in the receptor to which the drug binds in the brain cells and the biological transport mechanism responsible for the action of clozapine.

Two hundred patients who suffer from schizophrenia were involved in the study and were treated with clozapine for at least three months.

Professor Kerwin said: "The results of the genetic analysis show for the first time that it is possible to predict in 80% of cases those patients who will respond well to clozapine.

"This may lead to a simple new test to select patients most suited to this drug."

The study of genetic factors that influence a person's response to drug treatment - pharamacogenetics - is progressing rapidly.

Professor Kerwin said the research raises the possibility of personalised drug therapy.

"Our results show how we could, in the future, individualise psychiatric treatment in a group of people who respond in different ways to different drugs."

Muscle disorder

Dr Vincenzo Basile, from the centre for addiction and mental health (CAMH) at the University of Toronto in Canada, has conducted similar research into the muscular disorder tardive dyskinesia (TD) - a side effect of schizophrenia treatment that affects 20%-30% of patients.

In TD, a patient's muscles, particularly those of the face and tongue, move involuntarily and abnormally, and this distressing effect is often irreversible.

Dr Basile found that there could be a genetic association between the action of the brain receptors targeted by drug treatment, and the development of TD.

He said: "Psychiatric pharmacogenetics is still in its infancy and needs a good deal of refinement at statistical and clinical levels.

"However, we are already beginning to look at new techniques to identify those who might be vulnerable to side-effects of certain therapies - one of the major drawbacks of long-term treatment of schizophrenia.

"Pharmacogenetics is the new direction for future medicines. Theoretically, it could break the 'trial-and-error' approach to prescribing medicines for disorders like schizophrenia and may lead to individualized treatment based on a person's genetic make-up."

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See also:
31 Mar 99 |  Health
Patients face geographical care lottery
04 Aug 99 |  Health
Schizophrenics 'denied new drugs'
09 Nov 99 |  Health
Schizophrenia drug 'stimulates brain activity'

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