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Yıl:2010; Cilt: 3; Sayı: 1>> Özet
TAM METİN
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2010;3(1):60-66
Psikofarmakoloji ve Farmakogenetik
E Sağlam, İY Sağlam
Maltepe Üniversitesi Tıp Fakültesi
İlaca verilen cevapta oluşan kişisel farklılıklar klinikte yaşanan önemli problemlerden birisidir. İlaçlar vücuda alındıktan, atılana kadar, organizmadaki çeşitli proteinler ile etkileşirler. Bireyler arasındaki genetik farklılıklar, ilaç molekülünün etkileştiği proteinlerin yapısının bireye özgü farklar göstermesine neden olur. Sonuçta, tanısı aynı olan ve benzer özellikler gösteren hastalar, ilaçlara farklı yanıtlar verebilirler. Farmakogenetik; genetik farklılıklar sonucu ilaç yanıtında gözlenen bireyler arası değişiklikleri araştıran bilim dalıdır. Farmakogenetik çalışmalar, farmakoterapinin yetersiz ve/veya pahalı olduğu, psikiyatrik hastalıklar gibi, poligenik kompleks hastalıklarda özel öneme sahiptir. Psikiyatrik hastaların, %35-45’i tedaviye yanıt verip günlük hayatına dönebilirken, %30-50’si ya tedaviye cevap vermemekte yada günlük hayatının akışını bozacak şiddetli yan etkilere maruz kalmaktadır. Farmakogenetik çalışmalar, psikiyatrik hastalıkların tedavisinde kullanılan ilaçların hem farmakokinetiği hem de farmakodinamiği sürecinde görülen bireysel farklılıkların ilaçların etkinliği ve yan etkileri ile bağlantılı olduğunu göstermiştir. Psikiyatrik hastalıkların tedavisinde, farmakogenetik testler sonucunda bireyselleştirilmiş tedavilerin uygulanmasının, başarısızlık oranını, yan etki şiddet ve insidansını azaltacağı bilimsel gerçektir.
Psychopharmacology and Pharmacogenetics
Pharmacogenetics, the science dedicated to the identification of genes influencing response to pharmacotherapy. Pharmacogenetics holds some promise for improving the treatment of disorders by utilising information about genetic polymorphisms to match patients to the drug therapy that is the most effective with the fewest side effects. Pharmacogenetic research has expanded to cover most fields in medicine, acquiring special importance in complex diseases, including psychiatric diseases; many genes are implicated in determining variability at pharmacokinetic and pharmacodynamic level, where pharmacotherapy is insufficient and/or expensive. Only 35-45% of the patients respond to psychotropic therapies and return to functional level 30-50% of the patients will not respond sufficiently. The individual differences in therapeutic and adverse effects of psychotropic drugs are largely determined by genetic factors. Significant pharmacogenetic findings have been achieved in psychiatry, some of which have been translated into genetic prediction tests, leading to an improvement of response prediction and treatment selection.

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