CYP2D6 Phenotype Related to Ongoing Medication in Adults with Autistic Spectrum Disorder and Intellectual Disability

Background: Adults with autism spectrum disorder (ASD) and intellectual disability (ID) associated many comorbidities and drug prescriptions implying a wide polypharmacy with potential drug-drug interaction and suspicion of adverse drug reactions (ADR). Metabolizer phenotype could also influence on drug security profile. Objectives: To correlate the safety drug profile with CYP2D6 metabolizing phenotype in adults with ASD and ID. Methods: Ambispective, multicenter, pharmacovigilance trial (VIGITEA study), was develop in subjects with ASD and ID who attend or live in residential facilities. Characterization enzyme CYP2D6 metabolizer profile (Extensive metabolizer (EM), poor metabolizer (PM) and ultra-rapid metabolizer (UM), TEA-CYP study) was done by PCR and correlated to drug security profile (ADR, prescritions and polypharmacy as ≥ 5 simultaneous drug prescription). Statistycal analises were performed using R 3.5.1 and the study received Ethical Comitee Approval. Results: Eighty-three participants (30 ± 10 years old, 14% women, BMI 27±6 Kg/m2, 100% Caucasian, 57% on polypharmacy). The majority of comorbidities were related to the nervous system (33%). Suspicion ADR was associated more with antipsychotic medications (52%), specifically, risperidone (13%). Metabolizer CYP2D6 profile (EM 85%, PM 8%, UM 5%) associated a significantly higher dose prescription in EM phenotype. Conclusions: The evaluation and knowledge of the CYP2D6 metabolizer profile of the prescribed drug could help to a better dose selection in the most prevalent phentoype and, consequently could prevent the aparition of dose dependent suspected ADR.