Frequency of the Most Relevant Cytochrome Variants in Patients with Psychiatric Disorders

Aim of the study: To determine the frequency of CYP2D6, CYP2C9, CYP2C19, VKORC1 variants among the patients with psychiatric disorders. Objectives: 1. To evaluate the frequency of rapid and slow metabolism in a patient with mental illnesses. 2. To compare women and mans by the frequency of CYP’s genes. 3. To compare the frequency of CYP variants among patients with different mental illnesses Methods: After analysis of coded medical data it was determined sex, age, disease, type of metabolism in CYP2D6, CYP2C19, CYP2C19 and VKORC1. Based on the results of pharmacogenetic studies and data of age, sex, disease, the rates of CYP metabolism in fast and slow metabolizers are assessed, the groups of women and men are compared by CYP frequency, and the frequency of CYP variants in patients with different mental illnesses is determined. Study participants: Fifty-five patients with mental illnesses and behavior disorders at Family Medicine and Inmedica Clinics, for whom pharmacogenetic studies were performed due to prescription of drugs. Results and conclusions: Among the patients, CYP2C19, CYP2D6, VKORC1 rapid metabolism was found in 38.2%, 3.6% and 12.7% respectively. Slow degradation due to allelic variations of CYP2C19, CYP2C9, CYP2D6 and VKORC1 was respectively observed in 1.8%, 7.2%, 1.8% and 27.3% of all subjects. In the female group, normal-intensity CYP2C19 (45.5%), CYP2C9 (51.5%) and CYP2D6 (87.9%) genetic variants were the most common. In this group, 3.0% were CYP2C19 ultra-fast and poor, while 30.3% were rapid CYP2C19 metabolizers. An intermediate variant of CYP2C9 metabolism was identified in 42.4% of female patients. There were 3.0% of poor and 6.1% of ultra-rapid CYP2D6 variants among this group. In the male group, the normal-intensity genetic variant of CYP2C19, CYP2C9 and CYP2D6 were 40.9%, 50.0%, and 81.9% respectively. A variant of rapid CYP2C19 metabolism was identified in 40.9% of cases. The intermediate type of CYP2C9 metabolism was found in 41% of the patients. Nine percent were CYP2C9 poor metabolizers. No poor or ultra-fast metabolizers of CYP2D6 were identified in any of the male subjects. In this study it was found that 81.8% of the patients with depression and bipolar disorder had a normal intensity genetic variant of CYP2D6. Slow, intermediate intensity, fast and ultra - fast metabolism variants were each found in 4.5% of patients. CYP2C9 intermediate - intensity metabolism was observed in 54.5% of patients. Normal metabolism of CYP2C19 occurred in 40.9% of patients and slow metabolism in 4.5%. In the schizoaffective disorder group, normal - intensity metabolism was the most common: CYP2C19 – 23.1%, CYP2C9 – 76.9%, CYP2D6 – 76.9%. Ultra-fast metabolism CYP2C19 and CYP2D6 were both found in 7.7% of the investigated group. The CYP2C19 and CYP2D6 rapid metabolism phenotypes were 23.1% and 7.7%. No slow metabolism variants were identified in any of the subjects. No cases of CYP2D6, CYP2C9 and CYP2C19 in the slow or ultra-fast metabolism variant were observed in the group of patients with other diseases. Among these three enzymes, the normal type of metabolism accounted for the majority (CYP2D6 95.0%, CYP2C9 60.0%, CYP2C19 45.0%). Intermediate metabolism was observed in 5.0% of CYP2D6, 5.0% of CYP2C19 and 40.0% of CYP2C9