Psychiatry Investig.  2013 Sep;10(3):286-293.

CYP2D6 P34S Polymorphism and Outcomes of Escitalopram Treatment in Koreans with Major Depression

• Han KM
• Chang HS
• Choi IK
• Ham BJ
• Lee MS

Abstract

OBJECTIVE
Cytochrome P450 (CYP) enzymatic activity, which is influenced by CYP genetic polymorphism, is known to affect the inter-individual variation in the efficacy and tolerability of antidepressants in major depressive disorder (MDD). Escitalopram is metabolized by CYP2D6, and recent studies have reported a correlation between clinical outcomes and CYP2D6 genetic polymorphism. The purpose of this study was to determine the relationship between the CYP2D6 P34S polymorphism (C188T, rs1065852) and the efficacy of escitalopram treatment in Korean patients with MDD.
METHODS
A total of 94 patients diagnosed with MDD were recruited for the study and their symptoms were evaluated using the 21-item Hamilton Depression Rating scale (HAMD-21). The association between the CYP2D6 P34S polymorphism and the clinical outcomes (remission and response) was investigated after 1, 2, 4, 8, and 12 weeks of escitalopram treatment using multiple logistic regression analysis and chi2 test.
RESULTS
The proportion of P allele carriers (PP, PS) in remission status was greater than that of S allele homozygotes (SS) after 8 and 12 weeks of escitalopram treatment. Similarly, P allele carriers exhibited a greater treatment response after 8 and 12 weeks of escitalopram treatment than S allele homozygotes.
CONCLUSION
Our results suggest that the P allele of the CYP2D6 P34S polymorphism is a favorable factor in escitalopram treatment for MDD, and that the CYP2D6 P34S polymorphism may be a good genetic marker for predicting escitalopram treatment outcomes.

Keyword

CYP2D6 polymorphism; Major depressive disorder; Escitalopram; Treatment response

MeSH Terms

Alleles
Antidepressive Agents
Citalopram*
Cytochrome P-450 CYP2D6*
Cytochrome P-450 Enzyme System
Depression
Depressive Disorder, Major*
Genetic Markers
Homozygote
Humans
Logistic Models
Polymorphism, Genetic*
Antidepressive Agents
Citalopram
Cytochrome P-450 CYP2D6
Cytochrome P-450 Enzyme System
Genetic Markers