Although the efficacy of medications for attention-deficit/hyperactivity disorder
(ADHD) is well demonstrated in clinical trials, substantial numbers of patients fail
to remain on therapy, and there is tremendous variability in tolerability and treatment
acceptance. The emerging science of pharmacogenomics seeks to identify patterns of
genetic variation that will direct individually tailored treatment regimens and enhance
long-term adherence. For this review, existing studies in ADHD pharmacogenomics were
reviewed to assess current knowledge and provide a basis for planning future research.
Twelve studies were identified. The majority investigated the role of candidate genes
in predicting clinical response to methylphenidate. The most frequently studied is
DAT1, although findings are inconsistent, with the 10-repeat polymorphism predicting
both increased and decreased symptom reduction in various reports. Other candidates
include DRD4, DRD5, DBH, 5HTT, SNAP-25, and COMT. One study was based on quantitative
trait analyses in a genome-wide scan. Although interest in ADHD pharmacogenomics is
encouraging, preliminary studies have been limited by small sample sizes, inconsistent
research designs, retrospective reports, and a focus on symptom response. Future studies
should emphasize large, prospective trials, assess multiple medications in individual
subjects, and consider a full range of pharmacodynamic and pharmacokinetic outcomes.
Key Words
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Article info
Publication history
Published online: January 06, 2005
Accepted:
October 20,
2004
Received in revised form:
October 11,
2004
Received:
June 1,
2004
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
