Pharmacogenetic and pharmacogenomic research for the prediction of response to antipsychotics in schizophrenia

Treatment of schizophrenia sufferers requires the use of antipsychotic drugs. First developed in the 1950s, two major types of antipsychotics are currently available: classical or conventional antipsychotics and atypical antipsychotics. Selection of treatment is based on trial and error strategies with a detrimental effect on patients' prognosis and chances of recovery. Clinical and genetic indicators have been investigated as predictors of response to antipsychotic treatment. Several studies have reported association between clinical observations and treatment outcome. However, clinical indicators require post-treatment information that may delay selection of a beneficial drug. Alternatively, genetic polymorphisms have been suggested as useful pre-treatment predictors. In the last decade, pharmacogenetic researchers have reported numerous associations between antipsychotic response and polymorphisms in genes coding for drug-targeted receptors and metabolic enzymes. This research has provided information that can be used for the individual prediction of response to specific antipsychotics. Much more is expected from the surge of pharmacogenomic research in pharmaceutical companies. Novel targets for antipsychotic treatment, improved and safer drugs, and individualised treatment are some of the goals expected to achieve in the near future. (C) 2003 Wiley-Liss, Inc.