title: 31-year-old female shows marked improvement in depression, agitation, and panic attacks after genetic testing was used to inform treatment.
abstract: This case describes a 31-year-old female Caucasian patient with complaints of ongoing depression, agitation, and severe panic attacks. The patient was untreated until a recent unsuccessful trial of citalopram followed by venlafaxine which produced a partial response. Genetic testing was performed to assist in treatment decisions and revealed the patient to be heterozygous for polymorphisms in 5HT2C, ANK3, and MTHFR and homozygous for a polymorphism in SLC6A4 and the low activity (Met/Met) COMT allele. In response to genetic results and clinical presentation, venlafaxine was maintained and lamotrigine was added leading to remission of agitation and depression.
authors.affiliation: Centerstone, 1080 Ala Napunani Street No. 120, Honolulu, HI 96818, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lawrence
references.citation: Dialogues Clin Neurosci. 2009;11(4):427-34
references.pmid: 20135900
references.citation: Eur Neuropsychopharmacol. 2012 Apr;22(4):239-58
references.pmid: 22137564
references.citation: Neuropharmacology. 1997 Apr-May;36(4-5):621-9
references.pmid: 9225287
references.citation: Mol Psychiatry. 2009 May;14(5):487-91
references.pmid: 19088739
references.citation: J Neurochem. 1996 Jun;66(6):2621-4
references.pmid: 8632190
references.citation: Mol Psychiatry. 2006 Apr;11(4):352-60
references.pmid: 16402130
references.citation: PLoS One. 2013 Jun 14;8(6):e65662
references.pmid: 23799032
references.citation: Am J Hum Genet. 2004 Nov;75(5):807-21
references.pmid: 15457404
references.citation: Handb Exp Pharmacol. 2012;(209):349-56
references.pmid: 22249823
references.citation: Neuropsychopharmacology. 2011 Jan;36(1):133-52
references.pmid: 20631684
references.citation: Biol Mood Anxiety Disord. 2012 Oct 01;2:18
references.pmid: 23025490
references.citation: J Psychopharmacol. 1998;12(2):115-21
references.pmid: 9694022
references.citation: Front Genet. 2013 Jun 11;4:105
references.pmid: 23781230
references.citation: Mol Psychiatry. 2010 May;15(5):473-500
references.pmid: 18982004
references.citation: Lancet. 2002 Jun 15;359(9323):2086-7
references.pmid: 12086765
references.citation: Innov Clin Neurosci. 2011 Jan;8(1):19-28
references.pmid: 21311704
references.citation: Brain Behav Immun. 2011 Nov;25(8):1530-43
references.pmid: 21185933
references.citation: Am J Psychiatry. 2005 Mar;162(3):613-5
references.pmid: 15741483
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2005 Feb 5;133B(1):97-100
references.pmid: 15635667
references.citation: Genome Med. 2012 Jun 27;4(6):52
references.pmid: 22738351
references.citation: Arch Gen Psychiatry. 2003 Sep;60(9):889-96
references.pmid: 12963670
references.citation: Nat Genet. 2008 Sep;40(9):1056-8
references.pmid: 18711365