Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland.
Hospital District of Helsinki and Uusimaa, Helsinki, Finland.
Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden.
Finnish Institute for Health and Welfare (THL), Helsinki, Finland; University of Helsinki, Helsinki, Finland.
University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland; Department of Psychiatry, Turku University Hospital, Turku, Finland.
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Mehiläinen, Helsinki, Finland.
University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland; Department of Psychiatry, Turku University Hospital, Turku, Finland.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, MA, Cambridge, United States; Massachusetts General Hospital Massachusetts General Hospital, MA, Boston, United States.
Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Broad Institute of MIT and Harvard, MA, Cambridge, United States.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of psychiatry, Oulu University Hospital, Oulu, Finland.
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, MA, Cambridge, United States; Massachusetts General Hospital Massachusetts General Hospital, MA, Boston, United States.
Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Neuroscience Center, HiLIFE, University of Helsinki, Helsinki, Finland.
Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
Broad Institute of MIT and Harvard, MA, Cambridge, United States.
Broad Institute of MIT and Harvard, MA, Cambridge, United States.
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of psychiatry, Oulu University Hospital, Oulu, Finland.
Background: Non-adherence and negative attitudes towards medication are major problems in treating psychotic disorders. Cytochrome P450 2D6 (CYP2D6) contributes to the metabolism of aripiprazole and risperidone. Variations in CYP2D6 activity may affect treatment response or adverse effects. The impact of these variations on adherence and medication attitudes is unclear.
Aims: This study investigates the relationships between CYP2D6 phenotype, self-reported adherence, adverse effects, and attitudes among aripiprazole and risperidone users.
Methods: This study analyzed data from the SUPER-Finland cohort of 10,474 adults with psychotic episodes, including 1,429 aripiprazole and 828 risperidone users. The Attitudes towards neuroleptic treatment (ANT) questionnaire assessed adherence and adverse effects in all patients, while medication-related attitudes were examined in a subgroup of 1,000 participants. Associations between CYP2D6 phenotypes and outcomes were analyzed using logistic regression and beta regression in aripiprazole and risperidone groups separately.
Results: Among risperidone users, we observed no association between CYP2D6 phenotypes and adherence, adverse effects, or attitudes. Similarly, no link was found between adherence and CYP2D6 phenotypes among aripiprazole users. However, aripiprazole users with the ultrarapid CYP2D6 phenotype had more adverse effects (OR = 1.71, 95 % CI 1.03–2.90, p = 0.041). Among aripiprazole users, CYP2D6 ultrarapid phenotype was associated with less favorable attitudes towards antipsychotic treatment (β = -0.48, p = 0.023).
Conclusions: We found preliminary evidence that the ultrarapid CYP2D6 phenotype is associated with increased adverse effects and negative attitudes towards antipsychotic medication among aripiprazole users. CYP2D6 phenotype did not influence adherence, adverse effects, or attitudes among risperidone users.
Cambridge University Press, 2025.
Antipsychotic Agents, Cytochrome P-450 CYP2D6, Pharmacogenetics, Psychotic Disorders, Treatment Adherence and Compliance