- Meeting abstract
- Open Access
Insights from pharmacogenetic studies of antidepressants
Annals of General Psychiatry volume 9, Article number: S8 (2010)
Up to 60% of depressed patients do not respond completely to antidepressants and up to 30% do not respond at all. Among the many reasons leading to non-response, such as inadequate treatments and comorbid conditions, genetic factors as likely to contribute to up to 50% of variance in antidepressant response. Environmental factors, such as chronic stressors, psychosocial adjustment and personality traits may also influence response to treatment and interact with these. The investigation of both of these types of factors has been informative in genetic aetiological studies (e.g. Caspi et al., 2003) and is increasingly employed in pharmacogenetics.
A growing number of genetic variants have been replicated in terms of association with SSRI efficacy. They include polymorphisms in the serotonin transporter gene (5-HTTLPR), tryptophan hydroxylase gene (TPH), 5HT1A and 5HT2A receptors, the G-protein beta3-subunit (GNB3), Catechol-O-methyltransferase (COMT), the noradrenaline transporter (NAT), and dystrobrevin binding protein 1 (DTNBP1). Data indicating environmental stressors and temperamental traits as moderators of the effect of such genes on response to treatment will also be presented.
In conclusion, there are genetic and environmental factors that interact in a complex manner to impact on response to treatment with antidepressants. Increased understanding of these, including clinical characteristics such as "harm avoidance," may assist the clinician in deciding the best antidepressant to prescribe for a given patient.
Mandelli L, Mazza M, Martinotti G: Harm avoidance moderates the influence of serotonin transporter gene variants on treatment outcome in bipolar patients. J Affect Disord.
Mandelli L, Marino E, Pirovano A, Calati R: Interaction between SERTPR and stressful life events on response to antidepressant treatment. Eur Neuropsychopharmacol. 2009
Mandelli L, Serretti A, Marino E: Interaction between serotonin transporter gene, catechol-O-methyltransferase gene and stressful life events in mood disorders. Int J Neuropsychopharmacol. 2007, 10 (4): 437-47. 10.1017/S1461145706006882.
Müller DJ, Mandelli L, Serretti A: Serotonin transporter gene and adverse life events in adult ADHD. Am J Med Genet B Neuropsychiatr Genet. 2008, 147B (8): 1461-9. 10.1002/ajmg.b.30706.
About this article
Cite this article
Mandelli, L. Insights from pharmacogenetic studies of antidepressants. Ann Gen Psychiatry 9, S8 (2010). https://0-doi-org.brum.beds.ac.uk/10.1186/1744-859X-9-S1-S8
- Personality Trait
- Depressed Patient
- 5HT2A Receptor
- Serotonin Transporter