Pharamacogenetics and antidepressant treatment in integrative psychiatry perspective.
The concept of individualized drug therapy on the basis of pharmacogenetics has become a central focus in the treatment of depression. There is an increasing agreement about the importance of polymorphisms in cytochrome P450 enzymes and the effects of drug-drug interactions in relation to the incidence of adverse effects. There has been also increasing focus on the role of the drug transporter P-glycoprotein (P-gp) with regard to drug penetration into the brain. P-gp at the blood-brain barrier can exert a profound effect on the ability of some antidepressants to enter the brain. In addition, genetic polymorphism of the serotonin transporter has been investigated in relationship to the therapeutic response to several antidepressants, especially SSRIs. However, prediction of response on the basis of variants of candidate genes is incipient and remains elusive.
Mihaljević-Peles
Alma
A
University Psychiatric Clinic Rebro, Clinical Hospital Centre Zagreb, Kispatićeva 12, 10000 Zagreb, Croatia. apeles@mef.hr
Sagud
Marina
M
Bozina
Nada
N
Zivković
Maja
M
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism / Q000502:physiology*; D000928:Antidepressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000378:metabolism; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics / Q000378:metabolism; D003866:Depressive Disorder / Q000188:drug therapy* / Q000235:genetics; D004347:Drug Interactions / Q000235:genetics; D018432:Drug Resistance, Multiple / Q000235:genetics* / Q000502:physiology; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic / Q000235:genetics; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D017367:Selective Serotonin Reuptake Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use; D016896:Treatment Outcome
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000928:Antidepressive Agents; D019389:Cytochrome P-450 CYP2D6; D003577:Cytochrome P-450 Enzyme System; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors