Korean J Psychopharmacol.  2008 Sep;19(5):266-275.

An Association Study between Various Monoamine Transporter Gene Polymorphisms and Treatment Response to Mirtazapine in Major Depression

• Choi H
• Lim SW
• Kim SY
• Kim H
• Chung JW
• Kim DK

Abstract

OBJECTIVE
Genetic differences may contribute to the inter-individual differences in treatment response to antidepressants among patients suffering from major depression. This study investigated a possible association of various monoamine transporter genetic polymorphisms with treatment response to mirtazapine in major depressive patients in elderly.
METHODS
In this study, three genetic polymorphisms were selected: serotonin transporter 5- HTTLPR, serotonin transporter 5-HTT intron 2 VNTR, and norepinephrine transporter NET (G1287A). The patients with major depression diagnosed by DSM-IV were recruited to a 6 week naturalistic mirtazapine treatment study in Samsung Medical Center. Treatment response to mirtazapine was defined as > or =50% decrease in HAMD-17 scores at 6 weeks, and the genotypes in the patients were determined using the polymerase chain reaction.
RESULTS
Our results showed that ss allele carriers were included more in responder group (ss allele in responder vs. non responder group; 69.4% vs. 40.0%). In addition, l-allele (sl/ll) carriers were included less in responder group (sl/ll allele in responder vs. non responder group; 30.6% vs. 60.0%). Multiple logistic regression analyses showed the 5-HTTLPR polymorphism as an predictor of the mirtazapine response (5HTTLPR ss allele carrier vs. l-allele (sl/ll) carrier; odds ratio: 3.81; 95% confidence interval [CI], 1.32-11.0; p=0.013). However, 5-HTT intron 2 VNTR l/s (p=0.33 by multiple logistic regression; [OR], 0.53; 95% [CI], 0.15-1.88), and NET (G1287A) G/A (p=0.68 by multiple logistic regression; [OR], 1.25; 95% [CI], 0.44-3.53) showed no statistical significant influences on response rate.
CONCLUSION
In conclusion, 5HTTLPR polymorphism may predict treatment response to mirtazapine in major depressive patients in elderly.

Keyword

Mirtazapine; Genetic polymorphism; Major depression; Serotonin transporter; Norepinephrine transporter

MeSH Terms

Aged
Alleles
Antidepressive Agents
Depression
Diagnostic and Statistical Manual of Mental Disorders
Genotype
Humans
Introns
Logistic Models
Mianserin
Norepinephrine Plasma Membrane Transport Proteins
Polymerase Chain Reaction
Polymorphism, Genetic
Serotonin Plasma Membrane Transport Proteins
Stress, Psychological
Antidepressive Agents
Mianserin
Norepinephrine Plasma Membrane Transport Proteins
Serotonin Plasma Membrane Transport Proteins