The Pharmacogenetic Impact on the Pharmacokinetics of ADHD Medications

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

ADHD is a common condition in both children and adults. The most prescribed medications for the treatment of ADHD include methylphenidate, mixed amphetamine salts, atomoxetine, guanfacine, and clonidine. While each of these medications have their own distinct pharmacokinetic profile, the extent to which pharmacogenetics effects their pharmacokinetic parameters is best described in atomoxetine, followed by methylphenidate. Atomoxetine is predominantly metabolized by cytochrome p450 2D6 (CYP2D6), while methylphenidate is metabolized by carboxylesterase 1 (CES1). Both CYP2D6 and CES1 have multiple variants resulting in varying levels of enzyme activity; however, to date, the functional consequence of variants and alleles for CYP2D6 is better characterized as compared to CES1. Regarding CYP2D6, individuals who are poor metabolizers prescribed atomoxetine experience up to ten-fold higher exposure as compared to normal metabolizers at comparable dosing. Additionally, individuals prescribed methylphenidate with the rs71647871 variant may experience up to 2.5-fold higher exposure as compared to those without. Having this pharmacogenetic information available may aid clinicians and patients when choosing medications and doses to treat ADHD.

Original languageEnglish (US)
Title of host publicationMethods in Molecular Biology
PublisherHumana Press Inc.
Pages427-436
Number of pages10
Volume2547
DOIs
StatePublished - 2022

Publication series

NameMethods in Molecular Biology
Volume2547
ISSN (Print)1064-3745
ISSN (Electronic)1940-6029

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • ADHD
  • Atomoxetine
  • CES1
  • CYP2D6
  • Methylphenidate
  • Pharmacogenetics
  • Pharmacokinetics
  • Humans
  • Atomoxetine Hydrochloride/pharmacokinetics
  • Adult
  • Attention Deficit Disorder with Hyperactivity/drug therapy
  • Cytochrome P-450 CYP2D6/genetics
  • Child
  • Methylphenidate/therapeutic use

PubMed: MeSH publication types

  • Journal Article

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