What is it about?
Women and men psychiatric disease patients react differently to medications at the pharmacokinetics level (the time it takes the drug to reach the brain, accumulate and function there and be removed); side effects (like risk of bone fracture in women under some mental disease medications) and efficacy (for example, women show lower response to Alzheimer’s disease drugs). This could reflect different genes expressed by the two X chromosomes of women or one X and one Y chromosome in men; to sex-specific brain features; and to the different ageing processes.
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Why is it important?
Drug dose is currently determined by the patients’ body weight, disregarding their sex. However, the optimal dose depends on pharmacokinetics and should be calculated carefully. Likewise, an added risk of bone fracture should be avoided or at least acknowledged, and low efficacy due to wrong dose for women can be corrected. For all of these reasons, such differences must be acknowledged and corrected wherever possible.
Perspectives
Many of the brain-targeted drugs used currently were only tested in male rodents at the pre-clinical research phase, such that the first experience with women patients was only acquired at the clinical trials. Also, a major request of the FDA is to ensure that a new drug is as effective or better than previous drugs used for the same purpose; consequently, in many cases half of humanity is treated with drugs which were primarily developed and tested in animal models for the other half, which must be changed as soon as possible.
Hermona Soreq
Read the Original
This page is a summary of: Pharmaceutical Implications of Sex-Related RNA Divergence in Psychiatric Disorders, Trends in Pharmacological Sciences, November 2020, Elsevier,
DOI: 10.1016/j.tips.2020.09.003.
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