Аннотация:
Introduction. Patients with acute alcoholic hallucinosis require the administration of antipsychotic drugs, sometimes in combination with tranquilizers. In this case, psychopharmacotherapy is often ineffective, and various adverse drug reactions (ADRs) can develop against the background of their use. The studies conducted to date demonstrate the influence of polymorphism of genes encoding isoenzymes of cytochrome P-450 biotransformation and transport protein activity on the efficacy and safety of antipsychotics and benzodiazepines. The introduction of decision support systems capable of forming recommendations on the choice of drugs and doses based on the results of pharmacogenetic testing is an urgent task, the implementation of which will improve the effectiveness of therapy and reduce the risk of ADRs.
Aim: to compare the efficacy and safety of therapy selected with and without pharmacogenetic testing in patients with acute alcoholic hallucinosis.
Methods. The study was conducted on 48 Russian patients with an established diagnosis of acute alcoholic hallucinosis. Patients were randomized into either the main group (24 patients) or the control group (24 patients). Pharmacogenetic study was performed on all patients before treatment administration. Reports on the results of pharmacogenetic testing, on the basis of which the selection of drugs and their doses was performed, were available to the attending physicians of the patients in the main groups. Genotyping was performed by real-time polymerase chain reaction with allele-specific hybridization. Efficacy and safety were assessed using psychometric scales and scales to assess the severity of NLR: PANSS positive subscale and adverse effect assessment scale.
Results. It was found that by the sixth day of the study the number of UKU scale scores in patients of the main group and the control group differed statistically significantly between the compared groups (Main: 5.00 [3.00; 8.00] vs. Control: 12.00 [10.00; 16.00], p < 0.01).
Conclusions. Thus, it was demonstrated that the selection of drug dosage according to pharmacogenetic algorithms is able to reduce the risk of developing ADRs, which allows us to recommend the use of pharmacogenetic testing for drug dosage selection.
Ключевые слова:
pharmacogenetics, alcoholic hallucinosis, alcoholic psychosis, pharmacotherapy, personalized medicine.