References

psychiatry

ПСИХИАТРИЯ

Psychiatry (Moscow) (Psikhiatriya)

1683-83192618-6667

FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»

10.30629/2618-6667-2022-20-4-128-138

psychiatry-879

Research Article

НАУЧНЫЕ ОБЗОРЫ

SCIENTIFIC REVIEWS

Мониторинг эффективности антипсихотической терапии

Monitoring of the Antipsychotic Therapy Effectiveness

https://orcid.org/0000-0003-4950-5336

Мирошниченко

И. И.

Miroshnichenko

I. I.

Мирошниченко Игорь Иванович - доктор медицинских наук, заведующий лабораторией фармакокинетики.

Москва

Igor I. Miroshnichenko - Dr. of Sci. (Med.), Head of Pharmacokinetics Laboratory, Mental Health Research Centre.

Moscow

igormir@psychiatry.ru

Научный центр психического здоровьяРоссияMental Health Research CentreRussian Federation

2022

10012023

204128138

2023

Мирошниченко И.И.

Miroshnichenko I.I.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.journalpsychiatry.com/jour/article/view/879

Обоснование: концепция персонализированной медицины в диагностике и терапии психических расстройств олицетворяет индивидуальный подход к лечению на основе генотипа и фенотипа пациента. Цель: обсуждение основных современных подходов к индивидуализации психофармакотерапии: генотипирование, определение уровня биомаркеров и терапевтический лекарственный мониторинг (ТЛМ). Методы: базы данных медицинских и биологических публикаций (MEDLINE, PubMed); клинические наблюдения. Результаты: приведены примеры генетических тестов, позволяющих оптимизировать терапию психических заболеваний. Рассмотрена концепция биомаркеров как диагностических и терапевтических индикаторов в персонализированной медицине. Определены перспективные направления научного поиска: метаболизм, транспортеры, нейропередатчики (медиаторы), эпигенетика, а также популяционное моделирование фармакокинетики антипсихотиков. Приведены конкретные примеры ТЛМ содержания антипсихотиков. Заключение: рассмотренные направления исследований ориентированы на внедрение принципов персонализированной и трансляционной медицины в рутинную психиатрическую практику.

Background: there is seminal medicine direction in the diagnosis and therapy of mental disorders, namely personalized medicine. Its concept embodies an individual approach to treatment based on the genotype and phenotype of the patient. Objective: the presented paper deal with the main modern approaches to the individualization of psychopharmacotherapy: genotyping, determination of the level of biomarkers and therapeutic drug monitoring (TDM). Methods: databases of medical and biological publications (MEDLINE, PubMed); clinical observations. Results: examples of genetic tests that allow optimizing the therapy of mental illness are presented. The concept of biomarkers as diagnostic and therapeutic indicators in personalized medicine is considered. Other promising areas of scientific research are briefly described: metabolism, transporters, neurotransmitters (mediators), epigenetics. Population modeling of antibiotic pharmacokinetics also deserves attention. Specific examples of TDM content of antipsychotics are given. Conclusion: the reviewed research directions focused on the introduction of the principles of personalized and translational medicine into routine psychiatric practice.

персонализированная медицинафармакогенетикафармакокинетикашизофрениябиомаркерантипсихотикитерапевтический лекарственный мониторингмишенинейромедиаторы

personalized medicinepharmacogeneticspharmacokineticsbiomarkerschizophreniaantipsychotic drugs therapeutic drug monitoringtargetsneuromediators

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The authors declare that there are no conflicts of interest present.