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Effectiveness of certain antidepressants may be influenced by gene variations of individuals
October 04, 2006Whether specific types of antidepressants are effective for patients with late-life major depression may depend if they have certain genetic variations, according to a study in the October 4 issue of JAMA.
Initial drug treatments fail in 30 percent to 40 percent of patients with major depression. 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."
JAMA and Archives Journals
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."
JAMA and Archives Journals
Antidepressants Current Events and Antidepressants News RSSMen leave: Separation and divorce far more common when the wife is the patient
A woman is six times more likely to be separated or divorced soon after a diagnosis of cancer or multiple sclerosis than if a man in the relationship is the patient, according to a study that examined the role gender played in so-called "partner abandonment." The study also found that the longer the marriage the more likely it would remain intact.
Hunting for the Prozac Gene
Prozac works wonders for some depressed people, but not for others. In some cases, patients derive little benefit and at worst, it can lead to bizarre hallucinations and fits of rage.
Why antidepressants don't work for so many
More than half the people who take antidepressants for depression never get relief.
Study reveals an increase in long-term antidepressant drug use
A dramatic rise in antidepressant prescriptions issued by GPs has been caused by a year on year increase in the number of people taking antidepressant drugs on a long-term basis, according to researchers from the University of Southampton.
Popular antidepressant associated with a dramatic increase in suicidal thoughts amongst men
Nortriptyline has been found to cause a ten-fold increase in suicidal thoughts in men when compared to its competitor escitalopram. These findings are published in the open access journal BMC Medicine.
Antidepressant and placebo are equally effective in child pain relief
When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.
Antidepressants: benefit of SNRI is proven
The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Joint Committee (G-BA) to investigate whether patients with depression benefit from taking drugs belonging to the selective serotonin and norepinephrine reuptake inhibitor (SNRI) drug class.
Worth the effort? Not if you're depressed
New research indicates that decreased cravings for pleasure may be at the root of a core symptom of major depressive disorder. The research is in contrast to the long-held notion that those suffering from depression lack the ability to enjoy rewards, rather than the desire to seek them.
Almost 1 quarter of Spanish women take antidepressants
Psychopharmaceutical use has risen over recent years. This is fact, but what is not clear is the reason why.
Antidepressants aid electroconvulsive therapy in treating severe depression
Combining antidepressant drugs with electroconvulsive therapy (ECT) does a better job of reducing symptoms of severe depression and causes less memory loss than using ECT alone.
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