Pharmacogenetics and Obsessive-Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is a disorder that occupies the daily life of the patient.

OCD consists of repetitive and disturbing thoughts (obsessions/compulsion) and the activities that occur to get rid of these thoughts and to feel relieved (compulsions) (for instance: washing hands, lining things up, checking things). It is a chronic and compulsive disorder having various clinical appearances.

Pharmacological treatment (SSRI-type antidepressants) and psychotherapy (cognitive behavioral therapy) are recommended to be administered simultaneously for the OCD treatment. Nonetheless, there is a possibility of getting low outputs by 50% from the SSRI-type antidepressants. It is considered to be caused by personal differences. It was determined that the enzyme named “CYP450”, which is in charge of the absorption of antidepressant drugs, varies from person to person. The reason why this enzyme is different in everybody is the fact that it is genetically changed. On the other hand, epigenetic changes which are yet to be defined, in other words, the genetic structure changing through environmental and hereditary effects also limit the treatment of OCD. Furthermore, researches on genetics mention the complexity of the genetic appearance of OCD, which makes it difficult to find the suitable treatment.

The use of antidepressants, which are suitable for the genetic structure of the person, increases the possibility of getting a positive reaction to the drug during the treatment. In the researches carried out, a positive relation between the personalized pharmacological treatment and recovery. However, no association could be found between the negative reaction given to the pharmacological treatment and the length of the OCD duration, its early start, potency of the symptoms, their being chronic or the patient having been admitted to a hospital before.

The genetic structure of OCD was analyzed in a study carried out on families, twins and races. The fact that OCD is more prevalent in identical twins than fraternal twins shows that the genetic factors are quite effective. Starting from this point, it can be possible to find a suitable drug for the patient, considering the effectiveness of the pharmacological treatments administered to the relatives. In another study conducted, an association was found between the reactions given to the drugs used on the OCD treatment, and 6 genes related to serotonin and dopamine 5-HT2A, 5-HTT, DRD2, DRD4, COMT, MAOA).

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