Use of a Personalized Clinical Decision Support System for Dosing in Psychopharmacotherapy in Patients with Alcoholic Hallucinosis Based on Pharmacogenomic Markers

基于药物基因组学标记的酒精性幻觉症患者精神药物治疗剂量个性化临床决策支持系统的应用

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Abstract

INTRODUCTION: Alcoholic hallucinosis (AH) is one of the severe complications of chronic alcoholism, characterized by psychotic symptoms such as auditory hallucinations and delusions. Haloperidol is widely used to treat AH; however, its therapy is often complicated by side effects. A personalized approach using pharmacogenetic testing (particularly the CYP2D6 polymorphism) allows individualization of haloperidol dosage, improving both safety and efficacy of therapy. MATERIALS AND METHODS: The study included 100 men diagnosed with "psychotic disorder induced by alcohol use." Patients were randomized into two groups: the main group (45 patients) received haloperidol based on the results of pharmacogenetic testing, while the control group (55 patients) received standard dosing. Genotyping was conducted for the CYP2D6 1846G > A polymorphism. The effectiveness was assessed using the PANSS, UKU, and SAS scales. RESULTS: Genotyping showed an even distribution of CYP2D6 polymorphisms in both groups. The main group demonstrated a significant reduction in side effects and improvement in psychotic symptoms compared to the control group. Differences on the UKU, SAS, and PANSS scales reached statistical significance on days 3-5 of treatment. CONCLUSION: Using pharmacogenetic testing to adjust haloperidol dosage improves therapy tolerability and accelerates the resolution of psychotic symptoms in patients with alcoholic hallucinosis, confirming the feasibility of a personalized approach in psychopharmacotherapy.

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