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  • Clinical Implications
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Pharmacogenomics and schizophrenia: clinical implications

The Pharmacogenomics Journal volume 1, pages 109–114 (2001)Cite this article

Schizophrenia is a complex psychiatric disorder characterized by perceptual abnormalities including hallucinations and delusions, conceptual disorganization, cognitive impairment, and, frequently, the presence of negative symptoms such as alogia, affective flattening, and avolition.1 The lifetime prevalence of the disorder is approximately 1% and it is equally prevalent in men and women. Peak ages of onset for schizophrenia are ages 15–25 for men and 25–35 for women. The morbidity and mortality associated with schizophrenia is much greater than in the general population; patients with schizophrenia have a higher mortality rate from accidents and natural causes than the general population, more than 30% of patients meet criteria for substance abuse disorders, and approximately 10% of patients with schizophrenia die by suicide.2 Family, twin, and adoption studies have all suggested that schizophrenia has a prominent genetic component3 with heritability estimates as high as 80%.4 Moreover, significant linkage results have been reported across several genomic regions, although progress towards the ultimate identification of genetic variants that alter susceptibility to schizophrenia has been limited by the genetic complexity of the disorder.5

Antipsychotic drugs are the mainstay of treatment for schizophrenia. Chlorpromazine was introduced in the 1950s and resulted in significant improvement in the quality of life for many patients with schizophrenia, with a far greater proportion of patients able to live their lives without the restrictions of chronic inpatient hospitalization. Antipsychotic drugs treat many symptoms of the disorder, particularly the florid hallucinations and delusions, and the relapse rates of patients treated with antipsychotic drug treatment are two to four times less than patients treated with placebo.2 Unfortunately, these medications do not represent a cure for schizophrenia and treated patients often continue to experience psychotic symptoms. Moreover, the traditional antipsychotic agents such as chlorpromazine, haloperidol and thioridazine are associated with acute neuromuscular side effects (extra pyramidal symptoms or EPS) such as acute dystonic reactions and pseudo-parkinsonism, as well as the longer-term side effect of the potentially irreversible movement disorder, tardive dyskinesia (TD).6

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  1. Psychiatry Research, Hillside Hospital, Glen Oaks, NY, USA

    A K Malhotra

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Malhotra, A. Pharmacogenomics and schizophrenia: clinical implications. Pharmacogenomics J 1, 109–114 (2001). https://doi.org/10.1038/sj.tpj.6500038

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