Key result
Ziprasidone, olanzapine, and perazine show no link between gene polymorphisms and weight gain or EPS.
Why the study?
The associations between dopaminergic, serotonergic, and glutamatergic gene polymorphisms and adverse events after antipsychotic treatment in paranoid schizophrenia patients were unclear, as was the comparison of side effect intensity between atypical and typical antipsychotics.
Do specific gene polymorphisms predict adverse events (weight change and extrapyramidal symptoms) in paranoid schizophrenia patients treated with ziprasidone, olanzapine, or perazine?
RCT (n=191)
randomized
Do specific gene polymorphisms predict adverse events (weight change and extrapyramidal symptoms) in paranoid schizophrenia patients treated with ziprasidone, olanzapine, or perazine?
Selected gene polymorphisms do not appear to predict weight changes or extrapyramidal symptoms in schizophrenia patients treated with ziprasidone, olanzapine, or perazine.
Genetic links to antipsychotic adverse events remain hypothesis-generating; larger trials needed before informing personalized schizophrenia care.
The primary aim of the present study was to assess the possible associations between dopaminergic, serotonergic, and glutamatergic system-related genes and adverse events after antipsychotic treatment in paranoid schizophrenia patients. The second aim of the study was to compare the intensity of these symptoms between atypical (ziprasidone and olanzapine) and typical (perazine) antipsychotic drugs. Methods One hundred ninety-one Polish patients suffering from paranoid schizophrenia were genotyped for polymorphisms of DRD2, DAT1, COMT, MAOA, SERT, 5HT2A, and GRIK3. The patients were randomized to treatment with perazine, olanzapine or ziprasidone monotherapy for 3 months. The intensity of side effects (changes in body weights and extrapyramidal symptoms) was measured at baseline and after 12 weeks of antipsychotic treatment. Results After 3 months of therapy, the weight increase was the greatest in the group treated with olanzapine and the least in the group treated with ziprasidone. None of the examined gene polymorphisms was associated with the body weight changes. Perazine treatment was associated with the significantly highest intensity of extrapyramidal symptoms. None of the examined polymorphisms was associated with the changes in extrapyramidal adverse events after antipsychotic treatment. Conclusion The selected polymorphisms are not primarily involved in changes in body weights and extrapyramidal symptoms related to antipsychotic treatment in paranoid schizophrenia patients.
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Tybura et al. (2015) conducted an RCT in Paranoid schizophrenia (n=191). Ziprasidone, olanzapine, or perazine vs. Active comparators (ziprasidone, olanzapine, perazine) was evaluated on Associations between gene polymorphisms and adverse events (changes in body weight and extrapyramidal symptoms). Treatment with ziprasidone, olanzapine, or perazine for 3 months revealed no significant associations between the examined gene polymorphisms and adverse events like weight gain or EPS.
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