Clin Psychopharmacol Neurosci.  2012 Apr;10(1):49-53.

No Association between the Response to the Addition of an Atypical Antipsychotic Drug to an SSRI or SNRI and the BDNF (Val66Met) Polymorphism in Refractory Major Depressive Disorder in Japanese Patients

Affiliations
  • 1Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan. yoshi621@med.uoeh-u.ac.jp
  • 2Department of Psychiatry Research, The Zucker Hillside Hospital, New York, USA.
  • 3Department of Psychiatry, Fujita Health University, School of Medicine, Toyoake, Japan.

Abstract


OBJECTIVE
This study examined the association between the brain-derived neurotrophic factor (BDNF) (Val66Met) polymorphism and the response to the addition of an atypical antipsychotic drug to a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) in treatment-refractory depression.
METHODS
The study enrolled 64 patients meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for major depressive disorder who were treated with at least two courses of a single antidepressant, but who had Hamilton Depression Rating Scale (HAMD-17) scores > or =15 points that were reduced less than 50% over at least a 4-week treatment period. There were 24 males and 40 females (age range 27-68 years; mean+/-SD, 48+/-13 years). The patients' clinical improvement was evaluated using the HAMD-17. Patients with at least a 50% decrease in the HAMD-17 score were defined as responders. Serum BDNF levels were assayed using enzyme-linked immunosorbent assays and the presence of the BDNF (Val66Met) polymorphism was determined using the TaqMan genotyping assay.
RESULTS
No correlation was found between the BDNF (Val66Met) polymorphism and a positive response to adding an atypical antipsychotic drug. No differences were observed in the changes in the serum BDNF levels and HAMD-17 scores between Val66Val and Met-carriers. In addition, in patients who experienced remission, the atypical antipsychotic drug was discontinued after at least 3 months of treatment and the patients were then followed for 1 year; 14 of 27 patients (52%) relapsed within 1 year.
CONCLUSION
These results suggest that the BDNF (Val66Met) polymorphism is not associated with the response to the augmentation of a SSRI or SNRI with an atypical antipsychotic drug, and that the combination of an atypical antipsychotic drug and a SSRI or SNRI should be continued for 3 months or more in refractory depressed patients in the Japanese population.

Keyword

Brain-derived neurotrophic factor; Treatment-resistant depressive disorder; Antipsychotic drug; Polymorphism; Selective Serotonin Reuptake Inhibitor; Serotonin Norepinephrine Reuptake Inhibitor

MeSH Terms

Asian Continental Ancestry Group
Brain-Derived Neurotrophic Factor
Depression
Depressive Disorder, Major
Depressive Disorder, Treatment-Resistant
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Norepinephrine
Serotonin
Brain-Derived Neurotrophic Factor
Norepinephrine
Serotonin
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