Journal of International Psychiatry

[Abstract] Objective To investigate the effect of 5-hydroxytryptamine receptor 2A (HTR2A) rs6313 gene expression on blood concentration and clinical efficacy of olanzapine in the treatment of schizophrenia. Methods 110 patients with schizophrenia from January 2021 to June 2023 in the Second Hospital Affiliated to Hubei Institute of Science and Technology were included. HTR2A rs6313 gene expression was detected by real-time fluorescence quantitative polymerase chain reaction (PCR). According to the test results, they were categorized into CC-type, CT-type and TT-type groups. The olanzapine blood concentration and the positive and negative syndrome scale (PANSS) before and after treatment were compared at 4 and 8 weeks of treatment. Results Among 110 schizophrenic patients with HTR2A rs6313 gene allele, 39 cases were of CC type, 30 cases were of CT type, and 41 cases were of TT type. olanzapine blood concentration was significantly higher in CC type group than in TT type and CT type group at 4 and 8 weeks of treatment (P<0.05). CT type was significantly higher than TT type group (P<0.05). There was no statistically significant difference in PANSS scores among the three groups before treatment (P>0.05). PANSS scores were significantly lower after treatment, but CC type was significantly lower than TT type and CT type groups, and CT type group was significantly lower than TT type group (P<0.05). Conclusion Mutations at the 5HTR2A rs6313 locus may reduce blood levels of olanzapine in the treatment of schizophrenia and affect clinical efficacy.

Key words 5HTR2A Rs6313 Gene; Gene Expression; Olanzapine; Schizophrenia; Blood Concentration; Clinical Efficacy