|
Título:
|
Cytochrome P450 2C19 poor metabolizer phenotype in treatment resistant depression: Treatment and diagnostic implications
|
|
Autores:
|
Veldic, M. ;
Ahmed, A.T. ;
Blacker, C.J. ;
Geske, J.R. ;
Biernacka, J.M. ;
Borreggine, K.L. ;
Moore, K.M. ;
Prieto, M.L. ;
Vande Voort, J.L. ;
Croarkin, P.E. ;
Hoberg, A.A. ;
Kung, S. ;
Alarcon, R.D. ;
Keeth, N. ;
Singh, B. ;
Bobo, W.V. ;
Frye, M.A.
|
|
Tipo de documento:
|
texto impreso
|
|
Editorial:
|
Frontiers Media, 2019-12-06T20:57:50Z
|
|
Nota general:
|
info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
|
|
Idiomas:
|
Inglés
|
|
Palabras clave:
|
Editados por otras instituciones
,
Artículos
,
Artículos en revistas indizadas
|
|
Resumen:
|
Background: Pharmacogenomic testing, specifically for pharmacokinetic (PK) and pharmacodynamic (PD) genetic variation, may contribute to a better understanding of baseline genetic differences in patients seeking treatment for depression, which may further impact clinical antidepressant treatment recommendations. This study evaluated PK and PD genetic variation and the clinical use of such testing in treatment seeking patients with bipolar disorder (BP) and major depressive disorder (MDD) and history of multiple drug failures/treatment resistance. Methods: Consecutive depressed patients evaluated at the Mayo Clinic Depression Center over a 10-year study time frame (2003–2013) were included in this retrospective analysis. Diagnoses of BP or MDD were confirmed using a semi-structured diagnostic interview. Clinical rating scales included the Hamilton Rating Scale for Depression (HRSD24), Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Adverse Childhood Experiences (ACE) Questionnaire. Clinically selected patients underwent genotyping of cytochrome P450 CYP2D6/CYP2C19 and the serotonin transporter SLC6A4. PK and PD differences and whether clinicians incorporated test results in providing recommendations were compared between the two patient groups. Results: Of the 1795 patients, 167/523 (31.9%) with BP and 446/1272 (35.1%) with MDD were genotyped. Genotyped patients had significantly higher self-report measures of depression and anxiety compared to non-genotyped patients. There were significantly more CYP2C19 poor metabolizer (PM) phenotypes in BP (9.3%) vs. MDD patients (1.7%, p = 0.003); among participants with an S-allele, the rate of CYP2C19 PM phenotype was even higher in the BP (9.8%) vs. MDD (0.6%, p = 0.003). There was a significant difference in the distribution of SLC6A4 genotypes between BP (l/l = 28.1%, s/l = 59.3%, s/s = 12.6%) and MDD (l/l = 31.4%, s/l = 46.1%, s/s = 22.7%) patients (p
|
|
En línea:
|
http://repositorio.upch.edu.pe/handle/upch/7441
|
