Title:Optimization of Antidepressant Use with Pharmacogenetic Strategies
VOLUME: 18 ISSUE: 5
Author(s):Clara Torrellas, Juan Carlos Carril and Ramón Cacabelos*
Affiliation:EuroEspes Biomedical Research Center, Institute of Medical Sciences and Genomic Medicine, 15165-Bergondo, Corunna, EuroEspes Biomedical Research Center, Institute of Medical Sciences and Genomic Medicine, 15165-Bergondo, Corunna, EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, 15165- Bergondo, Corunna
Keywords:Pharmacogenetics, Antidepressant agents, Personalized medicine, Cytochrome P450 enzymes, Depression, Therapeutic
efficacy.
Abstract:Background: The response rate in the pharmacological treatment of depression has been
estimated to be around 50%, achieving a remission in symptomatology in only one third of the patients.
Suboptimal prescription of antidepressants has been proposed as a significant explanatory factor
for this therapeutic inefficacy. The use of pharmacogenetic testing might favor the optimization of
pharmacotherapy in emotional disorders. However, its implementation in the clinical routine requires
studies which prove its efficacy.
Objective: The aim is to explore the clinical effects obtained by means of the personalization of antidepressant
treatment derived from the pharmacogenetic profile of the individual.
Method: A sample of 291 patients under antidepressant treatment was selected, and these patients
were genotyped for the most common polymorphisms of the CYP2D6, CYP2C9, CYP2C19 and
CYP3A4/5 genes using RT-PCR and TaqMan® technology. 30 of them were subjected to psychoaffective
assessment using the HDRS scale before and after a process of individualization of their
psychopharmacological treatment in accordance with the genotype obtained.
Results: 70% of the individuals treated using the traditional criterion of trial-and-error were not taking
the active ingredient most suited to their pharmacogenetic profile. The inclusion of this genetic information
in the choice of drug and its dosage entailed a significant, progressive reduction in depressive
symptomatology, with an efficacy ratio of 80% and a remission of the pathology in almost 30% of the
cases.
Conclusion: These results suggest that the prescription of pharmacogenetic profile-based strategies
has a positive effect on the therapeutic response to antidepressants.
