Does the 5-HT1A rs6295 polymorphism influence the safetyand efficacy of citalopram therapy in the oldest old?

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Major depressive disorder (MDD) in older people is a relatively common, yet hard to treat problem. In this study we aimed to establish if a single nucleotide polymorphism in the 5- HT1A receptor gene (rs6295) determines antidepressant response in patients aged >80years (the oldest old) with MDD. 35Nineteen patients ≥80 years-old, with a new diagnosis of MDD were monitored for response to citalopram 20 mg daily over 4-weeks, and genotyped for the rs6295 allele. Both a frequentist and Bayesian analysis was performed on the data. Bayesian analysis answered the clinically relevant question: ‘what is the probability that an older patient would enter remission after commencing SSRI treatment, conditional on their rs6295 genotype?’. Individuals with a CC genotype showed a significant improvement in their Geriatric Depression Score (p=0.020) and cognition (p=0.035) compared to other genotypes. From a Bayesian perspective, we updated reports of antidepressant efficacy in older people with our data and calculated that the 4-week relative risk of entering remission, given a CC genotype, is 1.9 (95% HDI 0.7-3.5), compared to 0.52 (95% HDI 0.1-1.0) for the CG genotype. The sample size of n=19 is too small to draw any firm conclusions, however, the data suggest a trend indicative of a relationship between the rs6295 genotype and response to citalopram in older patients, which requires further investigation.
Original languageEnglish
Pages (from-to)355-366
JournalTherapeutic Advances in Drug Safety
Volume9
Issue number7
DOIs
Publication statusPublished - 23 Apr 2018

Fingerprint

Citalopram
Genotype
Major Depressive Disorder
Bayes Theorem
Antidepressive Agents
Therapeutics
Receptor, Serotonin, 5-HT1A
Geriatrics
Sample Size
Cognition
Single Nucleotide Polymorphism
Alleles
Depression
Genes

Bibliographical note

Does the 5-HT1A rs6295 polymorphism influence the safety and efficacy of citalopram therapy in the oldest old? Greg Scutt, Andrew Overall, Railton Scott, Bhavik Patel, Lamia Hachoumi, Mark Yeoman, and Juliet Wright Therapeutic Advances in Drug Safety . Copyright © 2018 The Author(s). Reprinted by permission of SAGE Publications.

Cite this

@article{ef809a22696944be9fa2f8926dd08bb8,
title = "Does the 5-HT1A rs6295 polymorphism influence the safetyand efficacy of citalopram therapy in the oldest old?",
abstract = "Major depressive disorder (MDD) in older people is a relatively common, yet hard to treat problem. In this study we aimed to establish if a single nucleotide polymorphism in the 5- HT1A receptor gene (rs6295) determines antidepressant response in patients aged >80years (the oldest old) with MDD. 35Nineteen patients ≥80 years-old, with a new diagnosis of MDD were monitored for response to citalopram 20 mg daily over 4-weeks, and genotyped for the rs6295 allele. Both a frequentist and Bayesian analysis was performed on the data. Bayesian analysis answered the clinically relevant question: ‘what is the probability that an older patient would enter remission after commencing SSRI treatment, conditional on their rs6295 genotype?’. Individuals with a CC genotype showed a significant improvement in their Geriatric Depression Score (p=0.020) and cognition (p=0.035) compared to other genotypes. From a Bayesian perspective, we updated reports of antidepressant efficacy in older people with our data and calculated that the 4-week relative risk of entering remission, given a CC genotype, is 1.9 (95{\%} HDI 0.7-3.5), compared to 0.52 (95{\%} HDI 0.1-1.0) for the CG genotype. The sample size of n=19 is too small to draw any firm conclusions, however, the data suggest a trend indicative of a relationship between the rs6295 genotype and response to citalopram in older patients, which requires further investigation.",
author = "Greg Scutt and Andrew Overall and Railton Scott and Bhavik Patel and Lamia Hachoumi and Mark Yeoman and Juliet Wright",
note = "Does the 5-HT1A rs6295 polymorphism influence the safety and efficacy of citalopram therapy in the oldest old? Greg Scutt, Andrew Overall, Railton Scott, Bhavik Patel, Lamia Hachoumi, Mark Yeoman, and Juliet Wright Therapeutic Advances in Drug Safety . Copyright {\circledC} 2018 The Author(s). Reprinted by permission of SAGE Publications.",
year = "2018",
month = "4",
day = "23",
doi = "10.1177/2042098618770620",
language = "English",
volume = "9",
pages = "355--366",
journal = "Therapeutic Advances in Drug Safety",
issn = "2042-0986",
number = "7",

}

Does the 5-HT1A rs6295 polymorphism influence the safetyand efficacy of citalopram therapy in the oldest old? / Scutt, Greg; Overall, Andrew; Scott, Railton; Patel, Bhavik; Hachoumi, Lamia; Yeoman, Mark; Wright, Juliet.

In: Therapeutic Advances in Drug Safety, Vol. 9, No. 7, 23.04.2018, p. 355-366.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Does the 5-HT1A rs6295 polymorphism influence the safetyand efficacy of citalopram therapy in the oldest old?

AU - Scutt, Greg

AU - Overall, Andrew

AU - Scott, Railton

AU - Patel, Bhavik

AU - Hachoumi, Lamia

AU - Yeoman, Mark

AU - Wright, Juliet

N1 - Does the 5-HT1A rs6295 polymorphism influence the safety and efficacy of citalopram therapy in the oldest old? Greg Scutt, Andrew Overall, Railton Scott, Bhavik Patel, Lamia Hachoumi, Mark Yeoman, and Juliet Wright Therapeutic Advances in Drug Safety . Copyright © 2018 The Author(s). Reprinted by permission of SAGE Publications.

PY - 2018/4/23

Y1 - 2018/4/23

N2 - Major depressive disorder (MDD) in older people is a relatively common, yet hard to treat problem. In this study we aimed to establish if a single nucleotide polymorphism in the 5- HT1A receptor gene (rs6295) determines antidepressant response in patients aged >80years (the oldest old) with MDD. 35Nineteen patients ≥80 years-old, with a new diagnosis of MDD were monitored for response to citalopram 20 mg daily over 4-weeks, and genotyped for the rs6295 allele. Both a frequentist and Bayesian analysis was performed on the data. Bayesian analysis answered the clinically relevant question: ‘what is the probability that an older patient would enter remission after commencing SSRI treatment, conditional on their rs6295 genotype?’. Individuals with a CC genotype showed a significant improvement in their Geriatric Depression Score (p=0.020) and cognition (p=0.035) compared to other genotypes. From a Bayesian perspective, we updated reports of antidepressant efficacy in older people with our data and calculated that the 4-week relative risk of entering remission, given a CC genotype, is 1.9 (95% HDI 0.7-3.5), compared to 0.52 (95% HDI 0.1-1.0) for the CG genotype. The sample size of n=19 is too small to draw any firm conclusions, however, the data suggest a trend indicative of a relationship between the rs6295 genotype and response to citalopram in older patients, which requires further investigation.

AB - Major depressive disorder (MDD) in older people is a relatively common, yet hard to treat problem. In this study we aimed to establish if a single nucleotide polymorphism in the 5- HT1A receptor gene (rs6295) determines antidepressant response in patients aged >80years (the oldest old) with MDD. 35Nineteen patients ≥80 years-old, with a new diagnosis of MDD were monitored for response to citalopram 20 mg daily over 4-weeks, and genotyped for the rs6295 allele. Both a frequentist and Bayesian analysis was performed on the data. Bayesian analysis answered the clinically relevant question: ‘what is the probability that an older patient would enter remission after commencing SSRI treatment, conditional on their rs6295 genotype?’. Individuals with a CC genotype showed a significant improvement in their Geriatric Depression Score (p=0.020) and cognition (p=0.035) compared to other genotypes. From a Bayesian perspective, we updated reports of antidepressant efficacy in older people with our data and calculated that the 4-week relative risk of entering remission, given a CC genotype, is 1.9 (95% HDI 0.7-3.5), compared to 0.52 (95% HDI 0.1-1.0) for the CG genotype. The sample size of n=19 is too small to draw any firm conclusions, however, the data suggest a trend indicative of a relationship between the rs6295 genotype and response to citalopram in older patients, which requires further investigation.

U2 - 10.1177/2042098618770620

DO - 10.1177/2042098618770620

M3 - Article

VL - 9

SP - 355

EP - 366

JO - Therapeutic Advances in Drug Safety

T2 - Therapeutic Advances in Drug Safety

JF - Therapeutic Advances in Drug Safety

SN - 2042-0986

IS - 7

ER -