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Pharmacogenetic polymorphisms and response to escitalopram and venlafaxine over 8 weeks in major depression
Author(s) -
Ng Chee,
Sarris Jerome,
Singh Ajeet,
Bousman Chad,
Byron Keith,
Peh Lai Huat,
Smith Deidre Joy,
Tan Chay Hoon,
Schweitzer Isaac
Publication year - 2013
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.2340
Subject(s) - escitalopram , clinical global impression , medicine , venlafaxine , odds ratio , major depressive disorder , 5 httlpr , depression (economics) , pharmacogenetics , citalopram , genotype , confidence interval , adverse effect , allele , psychiatry , psychology , gastroenterology , serotonin transporter , antidepressant , genetics , biology , serotonin , placebo , alternative medicine , receptor , macroeconomics , pathology , amygdala , gene , hippocampus , economics
Objective The objective of this study is to investigate the influence of the 5‐HTTLPR (serotonin transporter‐linked promoter region), cytochrome P450 2C19, and cytochrome P450 2D6 polymorphisms on escitalopram (ESC) and venlafaxine (VEN) responses in major depressive disorder. Method A prospective multi‐site study of 106 patients (Caucasian and Han Chinese ethnicities) with major depressive disorder treated with either ESC or VEN was conducted. The 17‐item Hamilton Depression scale (HDRS), Clinical Global Impression Scale, and an adverse events scale (UKU) were assessed over 8 weeks, blind to genotype. Results At the 8‐week end point, a significant HDRS reduction for both ESC and VEN occurred ( p < 0.0001). The 5‐HTTLPR l / l genotype was associated with significantly greater score reductions on the HDRS compared with s / s carriers ( p = 0.016) among Caucasian subjects receiving ESC ( n = 47). Response rates were significantly higher for l / l (92%) compared with l / s (61%) and s / s (46%) variants ( p = 0.042). For every l allele a participant carried, there was a 3.33 (95% confidence interval 1.25, 8.84; p = 0.02) times greater odds of ESC response. No significant associations between any of the genotypes and adverse effects were found. Conclusion Ethnicity may have differential effects on the 5‐HTTLPR genotype‐efficacy relationship. Results suggest that l / l allele for 5‐HTTLPR is associated with a robust treatment response to ESC in Caucasian subjects only. Copyright © 2013 John Wiley & Sons, Ltd.