title: Rapid response to paroxetine is associated with plasma paroxetine levels at 4 but not 8 weeks of treatment, and is independent of serotonin transporter promoter polymorphism in Japanese depressed patients.
abstract: In the present study, we investigated the relationship between the serotonin transporter gene linked polymorphic regions (5-HTTLPR) or plasma paroxetine levels and clinical response to paroxetine in depressed patients. Sixty patients who met the DSM-IV criteria for major depressive disorder were enrolled in the study. Twenty-two were male and 38 were female, with ages ranging from 25 to 71 (mean +/- SD = 42 +/- 16) years. The clinical improvement of patients was assessed using the Hamilton rating scale for depression (Ham-D) before and every week after paroxetine administration. According to the data reported previously, patients with an at least 50% decrease in their Ham-D score were classified as responders. The results showed that the plasma paroxetine levels at 4 weeks were significantly higher in responders (rapid responders) than in nonresponders. On the other hand, no significant associations were found between the L genotype (L/L, L/S) or S genotype (S/S) and the response rates either at 4 weeks or 8 weeks. These results suggest that patients with higher plasma levels at 4 weeks might respond rapidly to paroxetine treatment, but the final response rate at 8 weeks will be independent of the plasma paroxetine levels and the 5-HTTLPR L/S genotype.
authors.affiliation: Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan. yoshi621@med.uoeh-u.ac.jp
authors.forename: Reiji
authors.initials: R
authors.lastname: Yoshimura
authors.forename: Wakako
authors.initials: W
authors.lastname: Umene-Nakano
authors.forename: Akihito
authors.initials: A
authors.lastname: Suzuki
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Ueda
authors.forename: Kyoko
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Atsuko
authors.initials: A
authors.lastname: Ikenouchi-Sugita
authors.forename: Hikaru
authors.initials: H
authors.lastname: Hori
authors.forename: Koichi
authors.initials: K
authors.lastname: Otani
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000097:blood / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000097:blood / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D017374:Paroxetine; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human