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Edited by Bernard Lerer. Published by Cambridge University Press, Cambridge, 2002, pp 446, £95.00. ISBN 0-521-80617-8
In the introductory chapter of the book the author correctly states that the interface between genetics and pharmacology of psychoactive drugs is an ill known area. Knowledge of this field would interrelate nosology, genetics, and pharmacology, thus allowing choice of the most appropriate treatment for an individually identified patient affected by a specific disease. The subject is difficult to grasp, due to its complexity and to the paucity of solid data. Therefore, the book provides a number of viewpoints from which to address the issue: clinical and molecular background, and pharmacokinetics. This approach allows a focus of a number of methodological issues related to the general principles of pharmacogenetics.
The main section of the book deals with the pharmacogenetics of psychoactive drugs used to treat the most common psychiatric disorders. One of the main sources of complication is that each drug acts on more than one class of receptors and that multiple receptors’ activities are implied in the treatment of each psychiatric disorder. Genetic variability affects receptors for monoamines, thus influencing the response to psychotropic drugs. The ideal profile of activity on receptors is still not consistently defined, and each of the antipsychotic drugs used in clinical practice has a specific affinity profile. This is one important key for understanding clinical response to treatments, vulnerability to side effects, or improvement in some specific disease related issues such as cognitive performance.
Other important topics include the pharmacogenetics of anxiolytic drugs acting on the GABA–benzodiazepine complex, and a review of the genetic factors involved in the response to drug treatment for important diseases, such as bipolar mood disorders, epilepsy, Alzheimer’s disease, and drug dependence. This book provides a palette of information showing that, while as a discipline pharmacogenetics is still at the dawn of its development, it bears an important potential for implementing a thoughtful clinical practice.