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Abstract

Objective

The purpose of this study was to identify genetic variants underlying the considerable individual differences in response to antidepressant treatment. The authors performed a genome-wide association analysis of improvement of depression severity with two antidepressant drugs.

Method

High-quality Illumina Human610-quad chip genotyping data were available for 706 unrelated participants of European ancestry treated for major depression with escitalopram (N=394) or nortriptyline (N=312) over a 12-week period in the Genome-Based Therapeutic Drugs for Depression (GENDEP) project, a partially randomized open-label pharmacogenetic trial.

Results

Single nucleotide polymorphisms in two intergenic regions containing copy number variants on chromosomes 1 and 10 were associated with the outcome of treatment with escitalopram or nortriptyline at suggestive levels of significance and with a high posterior likelihood of true association. Drug-specific analyses revealed a genome-wide significant association between marker rs2500535 in the uronyl 2-sulphotransferase gene and response to nortriptyline. Response to escitalopram was best predicted by a marker in the interleukin-11 (IL11) gene. A set of 72 a priori-selected candidate genes did not show pharmacogenetic associations above a chance level, but an association with response to escitalopram was detected in the interleukin-6 gene, which is a close homologue of IL11.

Conclusions

While limited statistical power means that a number of true associations may have been missed, these results suggest that efficacy of antidepressants may be predicted by genetic markers other than traditional candidates. Genome-wide studies, if properly replicated, may thus be important steps in the elucidation of the genetic basis of pharmacological response.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 555 - 564
PubMed: 20360315

History

Received: 4 July 2009
Accepted: 22 October 2009
Published online: 1 May 2010
Published in print: May 2010

Authors

Affiliations

Rudolf Uher, M.D., Ph.D., M.R.C.Psych.
Neven Henigsberg, M.D.
Anna Placentino, Psy.D.
Marcella Rietschel, M.D.
Piotr M. Czerski, Ph.D.
Erik Roj Larsen, M.D., Ph.D.
Thomas G. Schulze, M.D.
Sarah Cohen-Woods, Ph.D.
Pierandrea Muglia, M.D.
Michael R. Barnes, Ph.D.
Anne Farmer, M.D., F.R.C.Psych.
Katherine J. Aitchison, M.D., M.R.C.Psych., Ph.D.
Cathryn M. Lewis, Ph.D.
Peter McGuffin, F.R.C.P., F.R.C.Psych., Ph.D.

Notes

Received July 4, 2009; revision received Sept. 24, 2009; accepted Oct. 22, 2009. From the Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London; the Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; the Croatian Institute for Brain Research, University of Zagreb Medical School, Zagreb, Croatia; the Department of Psychiatry, University of Bonn, Bonn, Germany; the Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark; the Biological Psychiatry Unit and Dual Diagnosis Ward, Istituto Di Ricovero e Cura a Carattere Scientifico, Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy; the Central Institute of Mental Health, Division of Genetic Epidemiology in Psychiatry, Mannheim, Germany; the Laboratoire de Psychologie Médicale, Université Libre de Bruxelles and Psy Pluriel, Centre Européen de Psychologie Médicale, Brussels; the Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia; the Department of Molecular and Biomedical Sciences, Jozef Stefan Institute, Ljubljana, Slovenia; the Clinic for Chronic Depression, Aarhus University Hospital, Risskov, Denmark; the Neurosciences Centre of Excellence in Drug Discovery, Glaxo­SmithKline R and D, Verona, Italy; the Department of Psychiatry, University of Toronto, Toronto; Computational Biology, GlaxoSmithKline Pharmaceuticals, Stevenage, Hertfordshire, United Kingdom; the Centre National de Genotypage, Evry Cedex, France. Address correspondence and reprint requests to Dr. Uher, P080 SGDP, Institute of Psychiatry, De Crespigny Park, SE5 8AF, London, United Kingdom; [email protected] (e-mail).

Competing Interests

Dr. Henigsberg has participated in clinical trials supported by GlaxoSmithKline and Lundbeck; he has also received honoraria from Lundbeck. Dr. Souery serves on the national advisory boards for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and Lundbeck. Drs. Muglia and Barnes are employed by GlaxoSmithKline. Drs. Farmer, Aitchison, and McGuffin have received consulting fees and honoraria from Glaxo­SmithKline and Lundbeck. Drs. Uher, Perroud, Ng, Hauser, Maier, Mors, Placentino, Rietschel, Žagar, Czerski, Larsen, Schulze, Zobel, Cohen-Woods, Butler, Lathrop, Breen, Craig, and Lewis and Mr. Jerman and Ms. Pirlo report no financial relationships with commercial interests.

Funding Information

The GENDEP project was supported by a European Commission Framework 6 grant (contract reference: LSHB-CT-2003-503428). Lundbeck provided nortriptyline and escitalopram free of charge for the project. GlaxoSmithKline, the Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London and South London, and the Maudsley National Health Service Foundation Trust (supported by the National Institute for Health Research, Department of Health, United Kingdom) provided support for add-on projects at the London recruitment center. The Medical Research Council, United Kingdom, and GlaxoSmithKline (G0701420) provided support for genotyping. The European Commission Framework, Lundbeck, GlaxoSmithKline, Biomedical Research Centre for Mental Health, Maudsley National Health Service Foundation, and Medical Research Council had no role in the design, conduct, data collection, analysis, interpretation, or writing of this study.EudraCT clinical trials registry number, 2004–001723-38 (http://eudract.emea.europa.eu) and International Standard Randomized Controlled Trials registry number, ISRCTN 03693000 (http://www.controlled-trials.com).

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