Prediction of remission of depression with clinical variables, neuropsychological performance, and serotonergic/dopaminergic gene polymorphisms

Hum Psychopharmacol. 2012 Nov;27(6):577-86. doi: 10.1002/hup.2267.

Abstract

Objective: The aim of our work is to study the possible role of clinical variables, neuropsychological performance, and the 5HTTLPR, rs25531, and val108/58Met COMT polymorphisms on the prediction of depression remission after 12 weeks' treatment with fluoxetine. These variables have been studied as potential predictors of depression remission, but they present poor prognostic sensitivity and specificity by themselves.

Methods: Seventy-two depressed patients were genotyped according to the aforementioned polymorphisms and were clinically and neuropsychologically assessed before a 12-week fluxetine treatment.

Results: Only the La allele of rs25531 polymorphism and the GG and AA forms of the val 108/158 Met polymorphism predict major depressive disorder remission after 12 weeks' treatment with fluoxetine. None of the clinical and neuropsychological variables studied predicted remission.

Conclusions: Our results suggest that clinical and neuropsychological variables can initially predict early response to fluoxetine and mask the predictive role of genetic variables; but in remission, where clinical and neuropsychological symptoms associated with depression tend to disappear thanks to the treatment administered, the polymorphisms studied are the only variables in our model capable of predicting remission. However, placebo effects that are difficult to control require cautious interpretation of the results.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use*
  • Catechol O-Methyltransferase / genetics*
  • Catechol O-Methyltransferase / metabolism
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / genetics*
  • Depressive Disorder, Major / physiopathology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Resistance
  • Female
  • Fluoxetine / therapeutic use*
  • Genetic Association Studies
  • Humans
  • Male
  • Mexico
  • Middle Aged
  • Neuropsychological Tests
  • Polymorphism, Genetic*
  • Polymorphism, Single Nucleotide
  • Prognosis
  • Remission Induction
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Serotonin Plasma Membrane Transport Proteins / genetics*
  • Serotonin Plasma Membrane Transport Proteins / metabolism

Substances

  • Antidepressive Agents
  • SLC6A4 protein, human
  • Serotonin Plasma Membrane Transport Proteins
  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Catechol O-Methyltransferase