title: Aberrant CYP2D6 metabolizer phenotypes do not show increased frequency in patients undergoing ECT after antidepressant therapy.
abstract: We investigated the accumulation of aberrant CYP2D6 genotypes and predicted metabolizer phenotypes (ultrarapid metabolizer, intermediate metabolizer and poor metabolizer) potentially affecting the antidepressant treatment response in depressive patients indicated for electroconvulsive therapy (ECT) compared with patients with a single episode of depression. Seventy-six Dutch White patients with unipolar or bipolar treatment-resistant depression who underwent ECT were genotyped using the Amplichip CYP450 Test for CYP2D6. Two hundred and eight patients with a single episode of unipolar or bipolar depression were used as controls. No difference was observed in the prevalence of CYP2D6 phenotypes (poor metabolizer, intermediate metabolizer, extensive metabolizer and ultrarapid metabolizer) between the ECT and the control patients (5.3, 38.7, 56.0 and 0.0% vs. 6.4, 51.0, 42.6 and 0.0%, respectively). The types of depression (odds ratio = 0.33, P = 0.018) and age (odds ratio = 1.55 for a 10-year increase, P < 0.001), but not CYP2D6 phenotype or activity score were associated with the response to antidepressant treatment. In conclusion, preemptive genotyping for CYP2D6 currently appears to have no clinical implications in treatment-resistant depressive patients indicated for ECT.
authors.affiliation: aDepartment of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital bDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA cDepartment of Clinical Pharmacy & Toxicology dDepartment of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands eDepartment of Clinical Chemistry, St Jansdal Hospital, Harderwijk, The Netherlands.
authors.forename: Hooman
authors.initials: H
authors.lastname: Mirzakhani
authors.forename: Juliët
authors.initials: J
authors.lastname: van Dormolen
authors.forename: Karen
authors.initials: K
authors.lastname: van der Weide
authors.forename: Henk-Jan
authors.initials: HJ
authors.lastname: Guchelaar
authors.forename: Martijn S
authors.initials: MS
authors.lastname: van Noorden
authors.forename: Jesse
authors.initials: J
authors.lastname: Swen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019389:Cytochrome P-450 CYP2D6 / Q000378:metabolism*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype
chemical_list: D000928:Antidepressive Agents; D019389:Cytochrome P-450 CYP2D6