The Effect of Cyp2d6 Gene Polymorphism on the Efficacy and Safety of Mirtazapine in Patients with Depressive Disorders Comorbid with Alcohol | Zendy

M. S. Zastrozhin | Zendy; Smirnov Vv | Zendy; Alexander S. Sorokin | Zendy; Е. А. Гришина | Zendy; Kristina Ryzhikova | Zendy; В. В. Шипицын | Zendy; Ludmila M. Savchenko | Zendy; Oleg Zh. Buzik | Zendy; Sergey S. Koporov | Zendy; Evgeny Bryun | Zendy; Д. А. Сычев | Zendy

Open Access

The Effect of Cyp2d6 Gene Polymorphism on the Efficacy and Safety of Mirtazapine in Patients with Depressive Disorders Comorbid with Alcohol

Author(s) -

M. S. Zastrozhin,

Smirnov Vv,

Alexander S. Sorokin,

Е. А. Гришина,

Kristina Ryzhikova,

В. В. Шипицын,

Ludmila M. Savchenko,

Oleg Zh. Buzik,

Sergey S. Koporov,

Evgeny Bryun,

Д. А. Сычев

Publication year - 2019

Publication title -

annals of the russian academy of medical sciences

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.122

H-Index - 15

eISSN - 2414-3545

pISSN - 0869-6047

DOI - 10.15690/vramn1075

Subject(s) - mirtazapine , alcohol use disorder , alcohol , cyp2d6 , polymorphism (computer science) , medicine , comorbidity , major depressive disorder , depressive symptoms , psychiatry , pharmacology , clinical psychology , gene , genetics , genotype , biology , antidepressant , cognition , anxiety , biochemistry

Background: Alcohol dependence is often combined with affective disorders, in particular, depressive disorder, which adversely affects the prognosis of the course of both diseases. For the treatment of a depressive disorder, drugs from the group of tetracyclic antidepressants, of which mirtazapine is a representative, are used. Therapy with mirtazapine is associated with the risk of undesirable drug reactions and pharmacoresistance. Aim: To study the effect of CYPD6 isoenzyme activity on the efficacy and safety of mirtazapine therapy in patients with depressive disorders comorbid with alcoholism. Methods: The study was conducted on 109 Russian patients with a depressive disorder, comorbid with alcohol dependence. For the correction of depressive disorders within the framework of cyclothymia, mirtazapine was prescribed to patients at a dosage of 1545 mg/day. CYP2D6*4 genotyping (1846G A, rs3892097) was carried out using Real-time polymerase chain reaction with allele-specific hybridization. Efficacy and safety were assessed using validated psychometric scales and an assessment of the severity of adverse drug reactions. Results: By the 9th day of the study, the severity of depressive symptoms on the HAMD scale was significantly different in patients with different genotypes: (GG) 7.0 [6.0; 8.0], (GA) 4.0 [3.8; 5.0] (p0.001), safety indicator, estimated on a UKU scale: (GG) 3.0 [3.0; 3.0], (GA) 4.0 [4.0; 5.0] (p0.001). The presence of differences persisted on the 16th day: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [0.8; 3.2] (p0.001), safety indicator, estimated on a UKU scale: (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p0.001). Conclusion: In this study, the effect of CYP2D6 gene polymorphism on the efficacy and safety of therapy with mirtazapine was demonstrated. Carrying a minor allele A is associated with an increased risk of adverse drug reactions, but improving performance profile performance.

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