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Polymorphism of the 5-HT transporter and response to antidepressants: randomised controlled trial.
- Source :
- British Journal of Psychiatry; Jun2011, Vol. 198 Issue 6, p464-471, 8p, 1 Diagram, 4 Charts
- Publication Year :
- 2011
-
Abstract
- <bold>Background: </bold>Antidepressants exhibit a variety of pharmacological actions including inhibition of the serotonin and noradrenaline transporters. We wished to investigate whether genetic variation could be used to target or personalise treatment, in a comparison of selective serotonin reuptake inhibitors (SSRIs) with noradrenaline reuptake inhibitors (NARIs).<bold>Aims: </bold>To test the hypothesis that patients homozygous for the long (insertion) polymorphism of the serotonin transporter (5-HTTLPR) have an increased response to SSRI antidepressants but not to NARI antidepressants.<bold>Method: </bold>In an individually randomised, parallel-group controlled trial, people meeting criteria for a depressive episode who were referred by their general practitioner were randomised to receive either citalopram (an SSRI) or reboxetine (an NARI). Randomisation was by means of a remote automated system accessed by telephone. The main outcome was depressive symptoms, measured by Beck Depression Inventory (BDI) total score 6 weeks after randomisation. The trial was registered with the International Standard Randomised Controlled Trials Number registry (ISRCTN31345163).<bold>Results: </bold>Altogether 298 participants were randomised to receive citalopram and 303 were randomised to reboxetine. At 6 weeks follow-up, complete data were available for 258 participants taking citalopram and 262 taking reboxetine. We found no evidence to support an influence of 5-HTTLPR on outcome following antidepressant treatment. The interaction term for BDI score at 6 weeks was 0.50 (95% CI -2.04 to 3.03, P = 0.70), which indicated that responses to the SSRI and NARI were similar irrespective of 5-HTTLPR genotype.<bold>Conclusions: </bold>It is unlikely that the 5-HTTLPR polymorphism alone will be clinically useful in predicting response to antidepressants in people with depression. [ABSTRACT FROM AUTHOR]
- Subjects :
- GENETIC polymorphisms
SEROTONIN
ANTIDEPRESSANTS
NORADRENALINE
PHARMACOKINETICS
Subjects
Details
- Language :
- English
- ISSN :
- 00071250
- Volume :
- 198
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- British Journal of Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 62657154
- Full Text :
- https://doi.org/10.1192/bjp.bp.110.082727