Lessons from Cuba for Global Precision Medicine: CYP2D6 Genotype Is Not a Robust Predictor of CYP2D6 Ultrarapid Metabolism.

A long-standing question and dilemma in precision medicine is whether and to what extent genotyping or phenotyping drug metabolizing enzymes such as CYP2D6 can be used in real-life global clinical and societal settings. Although in an ideal world using both genotype and phenotype biomarkers are desirable, this is not always feasible for economic and practical reasons. Moreover, an additional barrier for clinical implementation of precision medicine is the lack of correlation between genotype and phenotype, considering that most of the current methods include only genotyping.

Increased use of second generation antipsychotic drugs in primary care: potential relevance for hospitalizations in schizophrenia patients.

Aim: To analyze the changes in the prescribing pattern of antipsychotic drugs in primary care in Extremadura (Spain) from 1990 to 2005, and the potential association with schizophrenia hospitalization rate.

Methods: Data from 1990-2005 about the prescribing of antipsychotic drugs was drawn from all community pharmacy sales figures reimbursed by the Health System of Extremadura. Drug consumption figures were expressed as the number of defined daily doses per 1,000 inhabitants and per day of treatment (DDD/1,000/day).