Anticipated outcomes from introduction of 5-HTTLPR genotyping for depressed patients: an expert Delphi analysis

Public Health Genomics. 2010;13(7-8):406-14. doi: 10.1159/000313467. Epub 2010 Jul 6.

Abstract

Objective: The aim of this study was to investigate experts' opinions regarding the extent to which the introduction of pretesting for polymorphism of serotonin transporter promoter region (5-HTTLPR) as a routine intervention in clinical practice would lead to better clinical outcomes for depression patients.

Methods: Using an internet survey system, authors of clinical studies addressing the topic of association of 5-HTTLPR genotyping with antidepressant response were contacted to participate in a Delphi study.

Results: Responses from 12 experts were used for the final analysis. According to the participants, the introduction of 5-HTTLPR genotyping will lead to 33.8, 48.2, 57.8, and 65.1% of patients reaching remission at 1, 2, 3, and 6 months, respectively.

Conclusions: According to experts, application of 5-HTTLPR pretreatment genotyping might influence remission; however, the estimated remission rates with genotyping at first sight do not appear to be superior to existing practice, i.e. without genotyping. It is anticipated that a combination of 5-HTTLPR testing with other genomic variables, which have yet to be determined, and compliance measurements can improve clinical outcomes in the future. At present, the introduction of 5-HTTLPR genotyping is expected to be used only in special situations.

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Decision Support Techniques
  • Delphi Technique
  • Depressive Disorder / drug therapy
  • Depressive Disorder / genetics*
  • Genotype
  • Humans
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / genetics
  • Polymorphism, Genetic / genetics*
  • Prognosis
  • Promoter Regions, Genetic / genetics*
  • Randomized Controlled Trials as Topic
  • Remission Induction
  • Serotonin Plasma Membrane Transport Proteins / genetics*
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Serotonin Plasma Membrane Transport Proteins