MODERN TREATMENT APPROACHES IN PSYCHOSES . PHARMACOGENETIC , NEUROIMAGISTIC AND CLINICAL IMPLICATIONS

We approached the theme of modern pharmacological treatment strategies and the implication of pharmacogenetic testing in the management of child and adolescent psychoses. Our research was conducted in the period 2010 2015 on 210 patients, as follows: 150 children and adolescents with psychosis – a group of 75 children-G1, who benefited in choosing the pharmacotherapy from pharmacogenetic testing and 75 without testing-G2 and 60 children with UHR (ultra-high risk) for psychosis 30 benefited of pharmacotherapy after pharmacogenetic testing and 30 without. The patients were also evaluated through MR Spectroscopy at baseline and after pharmacotherapy. The efficacy of the chosen therapy in correlation with the pharmacogenetic testing was evaluated through the mean change in the PANSS (Positive And Negative Syndrome Scale) total scores of the applied scales and through the change registered for the relevant neurobiological markers and MR (magnetic resonance spectroscopy) metabolites, from baseline till endpoint in different timepoints. The pharmacogenetic testing was done through genotyping the SNP – single nucleotide polymorphisms through RT-PCR (polymerase chain reaction), after DNA extraction. Our results show statistically significant differences of the clinical scores between the studied groups: for the subjects who benefited of pharmacogenetic testing, the PANSS, the global functioning scores proved a higher clinical improvement, a better compliance and also an improvement concerning the MR spectroscopy dosed metabolites values. Our research was a proof, sustaining the use of the pharmacogenetic testing in clinical practice and the value of investigating relevant neurobiological and neuro-imagistic markers for a personalized, tailored therapy in child and adolescent psychosis and for UHR categories, as a fruitful pathway of intervention and care.