Systematic review identifies gene-drug associations for psychiatric treatments in Brazilian adults, suggesting routine pharmacogenetic testing remains premature.
Key Points
Synthesize evidence on the genetic determinants influencing antidepressant and antipsychotic treatment outcomes in Brazilian populations.
Systematic search across PubMed, Embase, BVS/Bireme, and Google Scholar through January 2026 (PROSPERO CRD42024533782).
Included observational studies conducted in Brazil that evaluated pharmacogenetic influences in adults receiving antidepressants or antipsychotics.
Analyzed 19 studies totaling 2,590 participants (46% female), identifying variants in CYP2C19, DRD1, DRD2, and CYP1A2 tied to clozapine safety and response in schizophrenia, alongside GAD1 variants linked to lower Glu/GABA ratios in bipolar disorder.
Identified that all CYP2C19 ultrarapid metabolizers with major depressive disorder required combination therapy to reach remission, while CYP2B6 rs2279343 AA was associated with improved bupropion efficacy for smoking cessation.
Observed HTR2A and HTR1B variants correlating with differential response in obsessive-compulsive disorder, although small cohort sizes precluded immediate clinical implementation.