Utilizing plasma drug levels and genetic testing to achieve optimal treatment response in a patient with treatment-resistant schizoaffective disorder,Bipolar Disorders

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Utilizing plasma drug levels and genetic testing to achieve optimal treatment response in a patient with treatment-resistant schizoaffective disorder
Bipolar Disorders ( IF 5.4 ) Pub Date : 2023-12-14 , DOI: 10.1111/bdi.13385
Jin‐jie Xu _{1,

2} , Chunfeng Xiao ₃ , Yanli Pan _{1,

2} , Yi‐lang Tang _{4,

5} , Mingwan Wang _{1,

2} , Sheng Li _{1,

2} , Gaoming Xie _{1,

2} , Jing Du _{1,

2} , Yanping Ren _{1,

2} , Wei Wang _{1,

2}

Affiliation

We report the case of a Chinese male with schizoaffective disorder, an active smoker and a nonresponder to clozapine (600 mg daily). Therapeutic clozapine monitoring was analyzed, revealing a low concentration-dose ratio. A pharmacogenetic test showed that the patient had the CYP1A2*1F/*1F genotype, indicating an ultra-rapid clozapine metabolizer. In combination with fluvoxamine, a CYP1A2 enzyme inhibitor, clozapine plasma concentrations approached the reference range and achieved clinical improvement. This case demonstrates how pharmacogenetics can help understand the value of therapeutic drug monitoring to enhance the treatment of refractory schizoaffective disorder.

更新日期：2023-12-14

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