Polygenic Risk Scores May Predict Antipsychotic Efficacy in Schizophrenia

The use of a polygenic risk score for schizophrenia can effectively predict an antipsychotic treatment response after a first episode of psychosis.

Polygenic risk scores, obtained from genome-wide association studies, may act as a prognostic biomarker for antipsychotic efficacy in patients with schizophrenia, according to study results published in the American Journal of Psychiatry.

Researchers prospectively studied a cohort of 77 patients with first-episode psychosis who were given either olanzapine or risperidone as initial antipsychotic treatment for 16 weeks. Psychotic symptoms were assessed using the Schedule for Affective Disorders and Schizophrenia rating scales at baseline, 12 weeks, or last follow-up visit. Polygenic risk scores were calculated using results from the genome-wide association study published by the Psychiatric Genomics Consortium.

After statistical analysis, investigators found that greater polygenic risk scores at 12 weeks significantly predicted increased psychotic symptom scores. In addition, higher scores were significantly associated with increased posttreatment symptoms in a combined analysis.

Primary study limitations included the small sample size and use of different antipsychotic drugs.

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“Patients with higher [polygenic risk scores] for schizophrenia tended to have less improvement with antipsychotic drug treatment. [Polygenic risk score burden] may have potential utility as a prognostic biomarker,” the researchers wrote.

Further studies are needed to fully understand the links between polygenic risk scores and schizophrenia.


Zhang JP, Robinson D, Yu J, et al. Schizophrenia polygenic risk score as a predictor of antipsychotic efficacy in first-episode psychosis. Am J Psychiatry. 2018:appiajp201817121363.