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1.
Article Ru | MEDLINE | ID: mdl-37994887

Cytochrome P450 (CYP450) is the leading enzyme in the biotransformation of most psychotropic drugs. CYP450 gene polymorphisms determine a patient's endophenotype with respect to the activity of enzymes of the family and affect the metabolism of prescribed antipsychotics and antidepressants. Categorizing patients by endophenotype during genotyping is likely to help simplify the selection of therapy in clinical practice. Co-prescribing drugs that may be inhibitors or inducers of CYP450 isoforms, in turn, may lead to adverse reactions or no effect of therapy. The article presents a compilation of known pharmacogenetic recommendations regarding the four major endophenotypes of metabolizers.


Antipsychotic Agents , Humans , Antipsychotic Agents/adverse effects , Cytochrome P-450 Enzyme System/genetics , Psychotropic Drugs , Antidepressive Agents/adverse effects , Pharmacogenetics/methods , Protein Isoforms/genetics , Genotype
2.
Article Ru | MEDLINE | ID: mdl-37084362

Despite the proven importance of neurosteroids in many physiological processes, their role in the pathogenesis of the most of psychiatric disorders remains relatively understudied. This article reviews the current clinical evidence on the effects of neurosteroids on the formation and treatment of anxiety disorder, depression, bipolar disorder, and schizophrenia. In particular, the article points out the ambivalent nature of the effects of neurosteroids on GABAA- and other receptors. We are especially interested in the anxiolytic and anxiogenic effects of some neurosteroids, the antidepressant effect of allopregnanolone in treating postpartum and other forms of depression, and the nature of short- and long-term mechanisms of antidepressant effects of neurosteroids of different types. The currently unproven hypothesis about the effect of changes in the level of neurosteroids on the course of bipolar disorder is also discussed, with an analysis of the scientific evidence on the development of schizophrenic symptomatology in relation to changing neurosteroid levels in the context of positive and cognitive symptoms.


Bipolar Disorder , Mental Disorders , Neurosteroids , Female , Humans , Neurosteroids/therapeutic use , Anxiety Disorders , Pregnanolone/therapeutic use , Pregnanolone/pharmacology , Pregnanolone/physiology
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