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Published Online: 1 September 2013

Determination of Genotype Combinations That Can Predict the Outcome of the Treatment of Alcohol Dependence Using the 5-HT3 Antagonist Ondansetron

Abstract

Objective

The authors previously reported that the 5′-HTTLPR-LL and rs1042173-TT (SLC6A4-LL/TT) genotypes in the serotonin transporter gene predicted a significant reduction in the severity of alcohol consumption among alcoholics receiving the 5-HT3 antagonist ondansetron. In this study, they explored additional markers of ondansetron treatment response in alcoholics by examining polymorphisms in the HTR3A and HTR3B genes, which regulate directly the function and binding of 5-HT3 receptors to ondansetron.

Method

The authors genotyped one rare and 18 common single-nucleotide polymorphisms in HTR3A and HTR3B in the same sample that they genotyped for SLC6A4-LL/TT in the previous randomized, double-blind, 11-week clinical trial. Participants were 283 European Americans who received oral ondansetron (4 µg/kg of body weight twice daily) or placebo along with weekly cognitive-behavioral therapy. Associations of individual and combined genotypes with treatment response on drinking outcomes were analyzed.

Results

Individuals carrying one or more of genotypes rs1150226-AG and rs1176713-GG in HTR3A and rs17614942-AC in HTR3B showed a significant overall mean difference between ondansetron and placebo in drinks per drinking day (−2.50; effect size=0.867), percentage of heavy drinking days (−20.58%; effect size=0.780), and percentage of days abstinent (18.18%; effect size=0.683). Combining these HTR3A/HTR3B and SLC6A4-LL/TT genotypes increased the target cohort from approaching 20% (identified in the previous study) to 34%.

Conclusions

The authors present initial evidence suggesting that a combined five-marker genotype panel can be used to predict the outcome of treatment of alcohol dependence with ondansetron. Additional, larger pharmacogenetic studies would help to validate these results.

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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: 1020 - 1031
PubMed: 23897038

History

Received: 4 September 2012
Revision received: 7 February 2013
Accepted: 8 April 2013
Published online: 1 September 2013
Published in print: September 2013

Authors

Details

Bankole A. Johnson, D.Sc., M.D.
From the Department of Psychiatry and Neurobehavioral Sciences and the Department of Public Health Sciences, University of Virginia, Charlottesville.
Chamindi Seneviratne, M.D.
From the Department of Psychiatry and Neurobehavioral Sciences and the Department of Public Health Sciences, University of Virginia, Charlottesville.
Xin-Qun Wang, M.S.
From the Department of Psychiatry and Neurobehavioral Sciences and the Department of Public Health Sciences, University of Virginia, Charlottesville.
Nassima Ait-Daoud, M.D.
From the Department of Psychiatry and Neurobehavioral Sciences and the Department of Public Health Sciences, University of Virginia, Charlottesville.
Ming D. Li, Ph.D.
From the Department of Psychiatry and Neurobehavioral Sciences and the Department of Public Health Sciences, University of Virginia, Charlottesville.

Notes

Address correspondence to Dr. Johnson ([email protected]).

Funding Information

Dr. Johnson has served as a consultant for ADial Pharmaceuticals (for which he also serves as Chairman), D&A Pharma, Eli Lilly, Organon, and Psychological Education Publishing Company. Dr. Li has served as a consultant and board member for ADial Pharmaceuticals. The other authors report no financial relationships with commercial interests.
Supplementary Material
The authors thank the National Institute on Alcohol Abuse and Alcoholism for its support through grants 5 R01 AA010522-17 and 1 R01 AA021163-01 (to Dr. Johnson) and grant 5 R01 AA019720-02 (to Dr. Ait-Daoud); the National Institute on Drug Abuse for its support of Dr. Li through grant 5 R01 DA012844-12; and Robert H. Cormier, Jr., B.A., for his assistance with manuscript preparation.

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