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CYP 2D6 genotyping in paediatric patients with autism treated with risperidone: a preliminary cohort study
Author(s) -
Youngster Ilan,
Zachor Ditza A,
Gabis Lidia V,
BarChaim Adina,
BenvenisteLevkovitz Patricia,
Britzi Malka,
Soback Stefan,
ZivBaran Tomer,
Berkovitch Matitiahu
Publication year - 2014
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12470
Subject(s) - risperidone , cyp2d6 , medicine , genotyping , cohort , autism , pediatrics , pervasive developmental disorder , pharmacogenetics , psychiatry , pharmacology , autism spectrum disorder , schizophrenia (object oriented programming) , genotype , cytochrome p450 , genetics , biology , metabolism , gene
Aim To evaluate the association between cytochrome P450 2D6 ( CYP 2D6) phenotypes in paediatric patients with autistic spectrum disorders ( ASD ) treated with risperidone, adverse drug reactions ( ADR s), and drug efficacy. Method An observational cohort study of 40 children (34 males, six females; median age 7y range 3–18y) with autistic disorder, pervasive developmental disorder not otherwise specified, or Asperger syndrome diagnosed using the Autism Diagnostic Interview‐Revised and treated with risperidone for at least 3 months. Charts were reviewed for demographic and clinical information, response to treatment was assessed by parents and the treating neurologist on a three‐point scale, and information about ADR s was collected. Trough plasma levels of risperidone and its metabolites were determined and CYP 2D6 genotyping was performed. Results Twenty‐six patients responded to therapy and 11 patients exhibited ADR s. CYP 2D6 genotyping showed two patients to be poor metabolizers, two ultra‐rapid metabolizers, seven intermediate metabolizers, and 29 extensive metabolizers. Both ultra‐rapid metabolizer patients were non‐responders and had no ADR s. In contrast, both poor metabolizer patients were responders but experienced ADR s. No correlation was found between risperidone dosage and either risperidone or drug metabolite plasma levels. There was no difference in risperidone or metabolite plasma levels when comparing responders to non‐responders, or when comparing patients with or without ADR s. Interpretation In patients with ASD treated with risperidone, a CYP 2D6 phenotype may be associated with response to treatment and development of ADR s.