Subject(s)
Antipsychotic Agents/adverse effects , Cardiac Output, Low/chemically induced , Cardiomyopathy, Dilated/chemically induced , Clozapine/administration & dosage , Panic Disorder/chemically induced , Schizophrenia/drug therapy , Schizophrenic Psychology , Adult , Antipsychotic Agents/therapeutic use , Bundle-Branch Block/chemically induced , Bundle-Branch Block/diagnosis , Cardiac Output, Low/diagnosis , Cardiac Output, Low/psychology , Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Dilated/psychology , Clozapine/therapeutic use , Diagnosis, Differential , Electrocardiography, Ambulatory , Follow-Up Studies , Humans , Male , Panic Disorder/diagnosis , Panic Disorder/psychology , Schizophrenia/diagnosis , Treatment Outcome , Ventricular Premature Complexes/chemically induced , Ventricular Premature Complexes/diagnosisABSTRACT
We present an overview of current progress and future directions in the molecular genetics of schizophrenia. We review linkage studies, involving the genome-wide scan of chromosomes with closely spaced polymorphic markers, and association studies of candidate genes, identified on the basis of receptors, neurotransmitters and response to certain drugs. The limitations of the research methodology involved in analyzing such a complex disorder are discussed, as are methods to strengthen this methodology with newer statistical and technological advances to give results that are replicable, statistically significant and applicable to a wider population. A greater understanding of the genetic mechanisms and the application of pharmacogenetics would lead to improvements in therapeutic interventions.
Subject(s)
Molecular Biology/methods , Schizophrenia/genetics , Chromosomes, Human, Pair 1/genetics , Chromosomes, Human, Pair 15/genetics , Chromosomes, Human, Pair 22/genetics , Chromosomes, Human, Pair 6/genetics , Genetic Markers , Genetic Predisposition to Disease , Genome, Human , Humans , Linkage Disequilibrium/genetics , Point Mutation/genetics , Polymorphism, Genetic/genetics , Receptors, Dopamine D1/genetics , Receptors, Dopamine D5 , Receptors, GABA/genetics , Receptors, N-Methyl-D-Aspartate/genetics , Receptors, Serotonin/genetics , Schizophrenia/drug therapy , Trinucleotide Repeats/geneticsABSTRACT
A 16-year-old boy developed fever, generalized rigidity, leukocytosis, and increased serum transaminase and creatine kinase levels while receiving treatment with olanzapine and lithium. When both drugs were discontinued, his fever and rigidity subsided and biochemical irregularities spontaneously returned to normal, without any complications. Classic neuroleptic malignant syndrome (NMS) was diagnosed. Concomitant administration of lithium with olanzapine may place patients at risk for NMS. Clinicians need to be aware of this rare but potentially fatal side effect in patients of all ages, and especially in adolescents receiving both drugs.
