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Efficacy of Antidepressant Depends on Genetics

Currently, initial drug treatments fail in 30 percent to 40 percent of patients with major depression. A study in JAMA reports analysis of individual genetic variations can help determine if a specific antidepressant will be effective for individuals who develop depression late in life.

Pharmacogenetic (the relation of genetic factors to variations in response to drugs) prediction of response is one possibility for improving antidepressant treatment, according to background information in the article. Polymorphisms (occurrence in more than one form) in the serotonin transporter gene (5-HTT) may influence antidepressant response to selective serotonin reuptake inhibitors (SSRIs – a class of antidepressant drugs).

Hyeran Kim, M.D., of Sungkyunkwan University School of Medicine, Seoul, Korea, and colleagues conducted a study to determine whether there were significant associations between the efficacy of norepinephrine reuptake inhibitors (NRIs – a class of antidepressant drugs) and norepinephrine transporter (NET) polymorphisms and also between SSRI efficacy and 5-HTT polymorphisms.

If confirmed, these associations could provide a basis for predicting response to certain antidepressants. The study included 241 Korean patients with major depression. They were treated for 6 weeks with an SSRI (fluoxetine or sertraline; n = 136) or an NRI (nortriptyline; n = 105) antidepressant. The average age at onset of major depressive disorder among these patients was in the early to mid-50s.

The researchers found that the presence of certain polymorphisms, alone or in combination, was associated with response and non-response to therapy with SSRIs or NRIs.

They write that their data analysis suggests that patients carrying the GG polymorphism of NET G1287A have a statistically significantly superior rate of response to NRI treatment than to SSRI treatment (83.3 percent vs. 58.7 percent).

“… this study demonstrates that the responses to antidepressants with different targets have significant associations with homologous monoamine transporter gene polymorphisms. Our data confirm a relationship between SSRI response and 5-HTT polymorphisms, and establish an association between NRI response and the NET G1287A polymorphism. We also found that the 5-HTTLPR s/l variation plays a role in the treatment of depression with both NRI and SSRI agents.

The results of this study need to be confirmed in other populations, using selective NRIs other than nortriptyline. Additional studies in younger populations with depression are also needed,” the researchers write. “Confirmation of these preliminary findings would permit refined pharmacogenetic selection of antidepressant treatment.”

Source: JAMA

Efficacy of Antidepressant Depends on Genetics

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Efficacy of Antidepressant Depends on Genetics. Psych Central. Retrieved on December 12, 2018, from https://psychcentral.com/news/2006/10/05/efficacy-of-antidepressant-depends-on-genetics/309.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.