The effects of the dopamine and serotonin transporter polymorphisms on clinical features and treatment response in geriatric depression: a pilot study.
BACKGROUND
The authors examined the role of dopamine and serotonin transporter genetic polymorphisms in clinical and cognitive features of subjects with late-life depression, and in preferential treatment response to the combination of methylphenidate and citalopram.


METHODS
The authors studied fifteen outpatients with major depression in a pilot ten-week double-blind trial of methylphenidate combined with citalopram and compared to citalopram and placebo. Response was defined as a score on the Hamilton Depression Rating Scale (24-item) of less than 10. All underwent genotyping to determine the dopamine (DAT VNTR) and serotonin (5HTTLPR) transporter polymorphisms.


RESULTS
Subjects with DAT VNTR 10/10 genotype had greater cognitive executive dysfunction at baseline compared to others. However, they responded preferentially to methylphenidate added to citalopram with a greater reduction in depression severity over time compared to other subjects.


CONCLUSIONS
DAT VNTR 10/10 genotype may be associated with an endophenotype of late-life depression with executive dysfunction that responds preferentially to methylphenidate added to a selective serotonin reuptake inhibitor, which warrants replication in a large sample.
Lavretsky
Helen
H
UCLA School of Medicine, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA. hlavrets@ucla.edu
Siddarth
Prabha
P
Kumar
Anand
A
Reynolds
Charles F
CF
D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics*; D050483:Dopamine Plasma Membrane Transport Proteins / Q000235:genetics*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D010865:Pilot Projects; D011110:Polymorphism, Genetic; D011569:Psychiatric Status Rating Scales; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000697:Central Nervous System Stimulants; D015283:Citalopram; D050483:Dopamine Plasma Membrane Transport Proteins; D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors