Angela Ibáñez Cuadrado

Consenso español de salud física del paciente con depresión

Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patients recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.

Pharmacogenetic study of antipsychotic induced acute extrapyramidal symptoms in a first episode psychosis cohort: role of dopamine, serotonin and glutamate candidate genes

This study investigated whether the risk of presenting antipsychotic (AP)-induced extrapyramidal symptoms (EPS) could be related to single-nucleotide polymorphisms (SNPs) in a naturalistic cohort of first episode psychosis (FEP) patients. Two hundred and two SNPs in 31 candidate genes (involved in dopamine, serotonin and glutamate pathways) were analyzed in the present study. One hundred and thirteen FEP patients (43 presenting EPS and 70 non-presenting EPS) treated with high-potency AP (amisulpride, paliperidone, risperidone and ziprasidone) were included in the analysis. The statistical analysis was adjusted by age, gender, AP dosage, AP combinations and concomitant treatments as covariates. Four SNPs in different genes (DRD2, SLC18A2, HTR2A and GRIK3) contributed significantly to the risk of EPS after correction for multiple testing (P<1 × 10−4). These findings support the involvement of dopamine, serotonin and glutamate pathways in AP-induced EPS.