Anticipated outcomes from introduction of 5-HTTLPR genotyping for depressed patients: an expert Delphi analysis.
OBJECTIVE
The aim of this study was to investigate experts' opinions regarding the extent to which the introduction of pretesting for polymorphism of serotonin transporter promoter region (5-HTTLPR) as a routine intervention in clinical practice would lead to better clinical outcomes for depression patients.


METHODS
Using an internet survey system, authors of clinical studies addressing the topic of association of 5-HTTLPR genotyping with antidepressant response were contacted to participate in a Delphi study.


RESULTS
Responses from 12 experts were used for the final analysis. According to the participants, the introduction of 5-HTTLPR genotyping will lead to 33.8, 48.2, 57.8, and 65.1% of patients reaching remission at 1, 2, 3, and 6 months, respectively.


CONCLUSIONS
According to experts, application of 5-HTTLPR pretreatment genotyping might influence remission; however, the estimated remission rates with genotyping at first sight do not appear to be superior to existing practice, i.e. without genotyping. It is anticipated that a combination of 5-HTTLPR testing with other genomic variables, which have yet to be determined, and compliance measurements can improve clinical outcomes in the future. At present, the introduction of 5-HTTLPR genotyping is expected to be used only in special situations.
Oestergaard
S
S
Department of Pharmacology and Pharmacotherapy, Section for Social Pharmacy, University of Copenhagen, Copenhagen, Denmark. soe@farma.ku.dk
Møldrup
C
C
D000928:Antidepressive Agents / Q000627:therapeutic use; D003661:Decision Support Techniques; D003697:Delphi Technique; D003866:Depressive Disorder / Q000188:drug therapy / Q000235:genetics*; D005838:Genotype; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000235:genetics; D011110:Polymorphism, Genetic / Q000235:genetics*; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics*; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D050486:Serotonin Plasma Membrane Transport Proteins