Janko Samardzic

By Janko Samardzic and Dubravka Svob Strac

Benzodiazepines (BDZs), which are among the most widely prescribed drugs in current psychiatric practice, act as positive modulators of GABAergic neurotransmission. They are used to treat a wide range of disorders, from anxiety, affective disorders and insomnia to epilepsy, alcohol withdrawal and muscle spasms. However, the development of tolerance and dependence after long‐term BDZ treatment, as well as the abuse potential, limit their use. Although some other classes of drugs are currently considered as a better choice for long‐term treatment, BDZs to date still remain indispensable drugs. They are widely prescribed for anxiety disorders, with high levels of evidence existing for the short‐term BDZ use in panic disorder and generalized anxiety disorder, intermediate for social anxiety and poor in post‐traumatic stress disorder and obsessive‐compulsive disorder. Future studies are intending to develop the new selective drugs that act via BDZ receptors, but with novel, narrow profile of action. Furthermore, the research on alternative therapeutic approaches of psychiatric disorders has shifted the focus onto therapeutic potential of natural BDZ ligands.

Part of the book: New Developments in Anxiety Disorders

By Janko Samardzic, Dragana Jadzic, Boris Hencic, Jasna Jancic and Dubravka Svob Strac

Part of the book: GABA And Glutamate

By Neha Tandon, Milica Brankovic, Aleksandar Popovic, Dubravka Svob Strac and Janko Samardzic

Pharmacogenomics is a crucial area in neuropsychopharmacology, offering a scientific foundation for precision medicine in treating psychiatric disorders, particularly schizophrenia spectrum disorders (SSD). Patients with SSD exhibit significant variability in their response to antipsychotic drugs, ranging from lack of efficacy to severe adverse drug reactions. This variability is largely due to genetic differences affecting drug metabolism (e.g., CYP450 enzymes such as CYP2D6 and CYP1A2) and drug targets (e.g., dopamine D2 and serotonin 2A receptors). For instance, an individual’s metabolizer status can dramatically alter drug concentrations, influencing both therapeutic effectiveness and the risk of side effects, such as weight gain and extrapyramidal symptoms. Recent advancements including multi-gene panels and multi-omics approaches (genomics, epigenomics, and metabolomics) are deepening our understanding of these complex drug responses. While promising case studies and clinical trial data highlight the predictive power of pharmacogenetics, its routine clinical integration faces substantial challenges. These include the need for standardized protocols, more robust real-world evidence, and improved omics literacy among healthcare providers. Overcoming these hurdles through collaborative efforts and technological advancements is essential to fully achieve the potential of pharmacogenomics in personalizing antipsychotic treatment, ultimately leading to improved patient outcomes and more effective mental healthcare.

Part of the book: Pharmacokinetics and Pharmacogenetics

By Janko Samardzic

Part of the book: Pharmacokinetics and Pharmacogenetics