Predictive factors for responding to sertraline treatment: views from plasma catecholamine metabolites and serotonin transporter polymorphism.
In the present study, we investigated the effects of sertraline on plasma levels of 3-methoxy-4-hydroxyphenylglycol (MHPG), homovanillic acid (HVA), and serum brain-derived neurotrophic factor (BDNF) levels in 59 depressed patients treated with sertraline. We also examined the relationship between the dynamics of the catecholamine metabolites, BDNF, serotonin transporter-linked polymorphic region (5-HTTLPR) gene polymorphism (long and short alleles), and the clinical response to sertraline. The extent of clinical improvement was evaluated using the 17-item Hamilton Rating Scale for Depression (Ham-D) before and 8 weeks after treatment with sertraline. Responders were defined as showing at least a 50% decrease in the Ham-D score. Baseline plasma HVA levels of responders to sertraline treatment were significantly lower than those of non-responders (p = 0.02). In addition, a positive correlation was identified between changes in plasma HVA levels and the rate of response to sertraline treatment (p = 0.001). A trend toward higher baseline serum BDNF levels was found in responders compared with non-responders (p = 0.095). In addition, serum BDNF levels were slightly increased (not significant) in responders (p = 0.058), but not in non-responders. Responders had a higher short-allele genotype frequency in the 5-HTTLPR for the promoter region than did non-responders (p = 0.037). These results suggest that pre-treatment plasma HVA levels and the 5-HTTLPR genotype for the promoter might be associated with a response to sertraline.
Umene-Nakano
Wakako
W
Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu, Fukuoka, Japan. wakako-u@med.uoeh-u.ac.jp
Yoshimura
Reiji
R
Ueda
Nobuhisa
N
Suzuki
Akihito
A
Ikenouchi-Sugita
Atsuko
A
Hori
Hikaru
H
Otani
Koichi
K
Nakamura
Jun
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D006719:Homovanillic Acid / Q000097:blood; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D020280:Sertraline / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
D019208:Brain-Derived Neurotrophic Factor; D006719:Homovanillic Acid; D008734:Methoxyhydroxyphenylglycol; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; C493230:SLC6A4 protein, human