Effectiveness and side effects of psychopharmacotherapy in individuals with 22q11.2 deletion syndrome with comorbid psychiatric disorders: a systematic review

• Published in: European child & adolescent psychiatry Vol. 29; no. 8; pp. 1035 - 1048
• Main Authors: Mosheva, Mariela, Korotkin, Liran, Gur, Raquel E., Weizman, Abraham, Gothelf, Doron
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2020; Springer Nature B.V
• Subjects: Antidepressants; Antipsychotics; Anxiety disorders; Attention deficit hyperactivity disorder; Child & adolescent psychiatry; Child and Adolescent Psychiatry; Clinical trials; Comorbidity; Data collection; Drug abuse; Drug therapy; Efficacy; Emotions; Evidence-based psychiatry; Forensic evidence; Medical treatment; Medicine; Medicine & Public Health; Mental disorders; Mental health services; Methionine; Mood; Pharmacology; Population studies; Psychiatry; Psychosis; Review; Serotonin reuptake inhibitors; Serotonin uptake inhibitors; Side effects; Stimulants; Systematic review; Treatment methods; Psychosis; Schizophrenia; ADHD; Velocardiofacial syndrome; Mood and anxiety disorders
• ISSN: 1018-8827; 1435-165X
• DOI: 10.1007/s00787-019-01326-4

22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion in humans and is associated with high rates of attention deficit/hyperactivity disorder (ADHD), psychotic spectrum disorders and mood and anxiety disorders. The objective of the study was to systematically review studies regarding pharmacological treatments for psychiatric disorders in individuals with 22q11.2DS and to provide practical guidelines for the psychiatric management and side effect monitoring in 22q11.2DS. A literature search was conducted using the databases PubMed, PsycINFO and Embase. Information regarding study population, drug treatment, side effect profile and efficacy for each trial was extracted. Data collection was completed on May 2018. The search identified 705 studies. A total of seven studies, describing 182 individuals, were included. Pharmacological interventions included three studies for antipsychotic treatment, two studies for stimulants, one study for selective serotonin reuptake inhibitors (SSRIs), one study for S -adenosyl- l -methionine (SAMe), and one case series for metyrosine. The presented data support the clinical impression that individuals with 22q11.2DS and comorbid psychiatric disorders are treated in a manner comparable to non-22q11.2DS individuals. However, distinct medical comorbidities common in individuals with 22q11.2DS may complicate the administration of pharmacotherapy. Further trials with RCT design, larger sample sizes and more syndrome-specific pharmacological agents are needed to improve evidence-based psychiatric care of 22q11.2DS individuals with comorbid mental disorders.