Objective To evaluate therapeutic efficacy of pharmacogenomics(PGx)-guided personalized treatment for patients with schizophrenia.Methods A total of 179 patients with schizophrenia were divided into an experience medication group(experience group,n=81;physician-guided antipsychotic drugs)and a personalized medication group(individual group,n=98,PGx-guided antipsychotic drugs).Both groups were followed up for 3 months.General clinical data of two groups of patients at admission were collected[age,residence,education level,marriage,residential situation,smoking history,drinking history,age of onset,family history of mental disorders,total disease course,systolic and diastolic blood pressures,heart rate,body mass,height,body mass index(BMI),and abdominal circumference].Oral mucosal epithelial cells were collected from the patients in individual group before treatment using oral swabs to extract DNA for PGx detection.Fasting venous blood from the patients in two groups in the morning was withdrawn before treatment and 3 months after treatment.Automated biochemical analyzer was used to detect whole blood lipids[triglycerides(TG)and cholesterol(CHOL)],fasting plasma glucose(Glu),and prolactin(PRL).The efficacy and social function of the patients in two groups before treatment and 3 months after treatment were evaluated using positive and negative syndrome scale(PANSS),clinical global impression(CGI)scale[including CGI-Global Improvement(CGI-GI,not measured before treatment),CGI-Severity of Illness(CGI-SI)],personal and social performance(PSP)scale and Global Assessment of Functioning(GAF)scale.Results There were statistically significant differences in the total score of PANSS,various factor scores and PANSS score reduction rate between individual and experience groups after treatment(P＜0.001),which were lower in individual group than in experience group.The differences in CGI-SI and CGI-GI scores were statistically significant between individual and experience groups after treatment(P＜0.05),and CGI-SI and CGI-GI scores were lower in individual group than in experience group.Except for PRL,there were no significant differences in the indexes for glucose metabolism and lipid metabolism between individual and experience groups after treatment(P＞0.05).PRL level was lower in individual group than that in experience group(P＜0.05).After treatment,the average scores of PSP and GAF in individual group were higher than those in experience group(P＜0.001).Conclusion PGx-guided personalized treatment may effectively improve the therapeutic efficacy of antipsychotic drug treatment in patients with schizophrenia,reduce the occurrence of hyperprolactinemia and improve social function of the patients.
维普
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