Patient's Genes May Guide Antidepressant Use

New study highlights DNA's importance to drug response

By Amanda Gardner
HealthDay Reporter

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TUESDAY, Oct. 3 (HealthDay News) -- New insights into how genes affect an individual's response to particular drugs could someday speed the effective treatment of depression, researchers say.

Reporting in the Oct. 4 issue of the Journal of the American Medical Association, scientists say variations in a serotonin transport gene accurately predicted which patients would respond to selective serotonin reuptake inhibitor (SSRI) drugs such as Prozac.

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They also identified key variations in the norepinephrine transporter (NET) gene. Those variants predicted response to nortriptyline, an antidepressant in a class of drugs called norepinephrine reuptake inhibitors (NRIs).

"I don't think this is going to change the way we treat depression, but it's another piece of the puzzle that will help us individualize treatment," said Dr. Julio Licinio, chairman of psychiatry at the University of Miami Miller School of Medicine. He was not involved in the research.

The study, conducted by researchers in the United States and Korea, shows "that it's important to look at gene variants in terms of treatment response," Licinio said.

Some 30 percent to 40 percent of patients fail their first drug treatment for major depression. Experts say that, right now, it's not possible to predict with any degree of accuracy which drug will work best for each patient.

Clinicians are pinning future hopes on "pharmacogenetics," or genetic factors that influence an individual's response to drugs.

There's reason for some optimism. Previous studies have shown that polymorphisms (individual differences in the DNA sequence) in the serotonin transporter gene might predict response to SSRIs, which include drugs such as Celexa, Paxil, Prozac and Zoloft.

Ethnic variations may also play a role. Prior studies have shown that gene variants linked to poor response to SSRIs among white patients were actually associated with a good response in Japanese and Korean patients.

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