Alexandra Žourková

Links among paroxetine-induced sexual dysfunctions, gender, and CYP2D6 activity.

The aim of the study was to compare the distribution of therapeutic efficacy and sexual dysfunction during maintenance paroxetine treatment in 17 males and 38 females genotyped and phenotyped to determine their CYP2D6 metabolic status. Clinical results were monitored on scales Clinical Global Impression-Severity of Illness Scale (CGIS) and Arizona Sexual Experience Scale (ASEX). The phenotype procedure showed 7 males and 12 females with extensive metabolic status (EM) and 10 males and 26 females with poor metabolic status (PM). No variation in therapeutic efficacy between male and female subjects classified as PM and those marked as EM was found. A significantly higher rate of sexual dysfunction (p = 0.01) was recorded among females with a PM phenotype.

MDR1 in Paroxetine-Induced Sexual Dysfunction

Paroxetine-induced sexual dysfunction represents a frequent treatment complication of otherwise efficient antidepressants. The genetic polymorphism of pharmacokinetic genes may contribute to the occurrence of such dysfunctions. This study presents the effect of MDR1 gene polymorphisms on sexual function in 18 women with bulimia nervosa, 18 women with anxiety disorders, and 19 healthy control subjects. It also deals with the relation between MDR1 gene polymorphisms and paroxetine-induced sexual dysfunction. The results demonstrated that MDR1 G2677T/A gene polymorphism allele carriers treated with paroxetine presented with difficulties with orgasm (p = .008) and lubrication (p < .001).

P.2.030 Olanzapine versus risperidone in first-episode schizophrenic and schizoform disorders: A double-blind comparison

In double-blind randomized trial olanzapine was more suitable antipsychotic for the treatment of first-episode psychoses for the greater final improvement, better reduction of negative symptoms a fewer extrapyramidal side -effects and hyperprolactinemia than risperidone

Dynamics and persistence of CYP2D6 inhibition by paroxetine

Paroxetine is both a substrate and an inhibitor of CYP2D6. The objective of the presented study was to determine the persistence of CYP2D6 inhibition after short term (6 weeks) and long term (18·7 ± 10·6 weeks) paroxetine treatment.

Gender differences in efficacy and sexual function in long-term trazodone treatment (preliminary results).

Objects. To evaluate the effect of trazodone on depressive or anxiety symptoms and sexual function depending on patient gender. Method. A total of 111 patients (59 men, 52 women) subjected to long-term treatment with trazodone were studied. The effect of the therapy was recorded according to the Clinical Global Impression – Severity of Illness (CGI-S) scale. The incidence of sexual dysfunction was assessed on the Utvalg for Kliniske Undersogelser (UKU) scale. Results. The effect of the therapy was similar in both genders. The incidence of diminished sexual desire was low and comparable in both genders; orgasmic dysfunctions were present only in women at the level of statistical significance. A positive correlation between the severity of the illness and the occurrence of diminished sexual desire and orgasmic dysfunction was found in women but not in men. Conclusion. The occurrence of sexual dysfunctions in trazodone therapy was lower than in population. It seems that trazodone is an effective therapy of depressive and anxiety symptoms in both genders and it is convenient for sexually active patients, because the occurrence of sexual dysfunctions was present the general to a low degree.

P.1.146 Sertraline versus amitriptyline in the treatment of in-patients with acute depressive disorders

In double-blind trial the antidepressant effect of sertraline did not differ significantly from that of amitriptyline and the in-patients with depressive disorder tolerated sertraline better than amitriptyline

P02-451 - Comparison of risperidone response rate between different CYP2D6 metabolisers

Introduction Risperidone is an antipsychotic used as the first-line treatment of schizophrenia. Risperidone is metabolised by enzyme CYP2D6. Activity of this enzyme can be predicted by genotypization. Objectives To explore the possibility of different response rate to risperidone in first-episode schizophrenia patients with different CYP2D6 genotype. Aim To asses the utility of CYP2D6 pharmacogenetic testing in patients with schizophrenia treated with risperidone. Methods CYP2D6 genotype was assessed in 22 first-episode schizophrenic patients by use of automatic sequencing of DNA isolated from peripheral leukocytes. PANSS score was assessed every week of treatment until the change in medication or patient release. Response was defined as at least 30% reduction in total PANSS. Differences in response rate between groups were tested by Fishers exact test. Results 10 CYP2D6 extensive metabolisers (EM), 8 intermediate metabolisers (IM) and 4 poor metabolisers (PM) were identified. Criteria for response met 4 EM, 4 IM and 1 PM. Differences in response rate between groups were not statistically significant. Conclusions Although group of IM had higher response rate than EM and PM, differences in response rate did not reach statistical significance. Further differences may be found by extending the sample size. An useful approach would be also to examine differences in occurrence of adverse effects and subjective tolerance of the treatment. Acknowledgement The study was supported by the grant of Czech Ministry of Health No. NS 9676-4/2008.