MODERN TREATMENT APPROACHES IN PSYCHOSES.
PHARMACOGENETIC, NEUROIMAGISTIC AND CLINICAL
IMPLICATIONS
LAURA NUSSBAUM1#*, LAVINIA MARIA HOGEA2#, DANIELA CĂLINA3#, NICOLETA ANDREESCU4, RALUCA GRĂDINARU4, RADU ȘTEFĂNESCU5, MARIA PUIU4
1Pedopsychiatry Discipline, Department of Neurosciences, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie
Murgu Square, Timișoara, Romania
2Psychology Discipline, Department of Neurosciences, “Victor Babeș” University of Medicine and Pharmacy, 14 Tudor
Vladimirescu Street, Timișoara, Romania
3Clinical Pharmacy Department, University of Medicine and Pharmacy, Faculty of Pharmacy, 2 Petru Rareș Street, 200349,
Craiova, Romania
4Genetics Discipline, Microscopic Morphology Department, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie
Murgu Square, Timișoara, Romania
5“Titu Maiorescu” University, School of Medicine, Bucharest, Romania
*corresponding author: nussbaumlaura@yahoo.com
#These authors contributed equally to this work and thus share first authorship.
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Abstract:
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.

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