A systematic review of genome-wide association studies of antipsychotic response

Pharmacogenomics. 2019 Mar;20(4):291-306. doi: 10.2217/pgs-2018-0163. Epub 2019 Mar 18.

Abstract

Clinical symptom response to antipsychotic medications is highly variable. Genome-wide association studies (GWAS) provide a 'hypothesis-free' method of interrogating the genome for biomarkers of antipsychotic response. We performed a systematic review of GWAS findings for antipsychotic efficacy or effectiveness. 14 studies met our inclusion criteria, ten of which examined antipsychotic response using quantitative rating scales to measure symptom improvement. 15 genome-wide significant loci were identified, seven of which were replicated in other antipsychotic GWAS publications: CNTNAP5, GRID2, GRM7, 8q24 (KCNK9), PCDH7, SLC1A1 and TNIK. Notably, four replicated loci are involved in glutamatergic pathways. Additional validation and evaluation of the biological significance of these markers is warranted. These markers should also be evaluated for clinical utility, especially in the context of other validated pharmacogenomic variants (e.g., CYP450 genes). These findings may generate new avenues for development of novel antipsychotic treatments.

Keywords: GWAS; antipsychotic; genome-wide association study; pharmacogenomics; psychopharmacology; schizophrenia; systematic review; treatment response.

Publication types

  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Genome-Wide Association Study*
  • Humans
  • Pharmacogenetics / methods
  • Pharmacogenomic Variants / genetics
  • Polymorphism, Single Nucleotide / genetics
  • Schizophrenia / drug therapy*
  • Schizophrenia / epidemiology
  • Schizophrenia / genetics

Substances

  • Antipsychotic Agents