Predicting the effectiveness of pharmacotherapy in patients with depressive disorders based on genetic parameters

Predicting the effectiveness of pharmacotherapy in patients with depressive disorders based on genetic parameters

 

Authors

 

N.M. Vyalova

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

G.G. Simutkin

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

S.A. Ivanova

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

 

https://doi.org/10.26617/1810-3111-2024-3(124)-28-35

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2024; 3 (124):  28-35.

 

Abstract

Introduction. Depression as a multifactorial, heterogeneous disease is determined not only by unfavorable environmental factors, but also by the impact of many genes, their mutual influence, which justifies the expediency of using genetic methods of laboratory diagnostics in the assessment and prognosis of depressive symptoms. Objective: to develop a medical technology for predicting the remission in patients with depressive disorders under psychopharmacotherapy based on genetic indicators. Materials and Methods. The study included 339 patients with depressive disorders (F32 and F33 according to ICD-10), undergoing treatment at the clinic of Mental Health Research Institute, Tomsk National Research Medical Center. The mean age of patients was 49.7±11.6 years. The severity of the current depressive episode was assessed using the Hamilton Depression Rating Scale (HDRS-17). The presence of remission was assessed by day 28 of the therapy. Genomic DNA of patients was isolated with subsequent genotyping using real-time PCR. Results. A new medical technology was developed that introduced a method for predicting the effective-ness of pharmacotherapy in patients with depressive disorders based on the determination of clinical, sociodemographic and molecular genetic indicators. Using logistic regression, a statistically significant association of remission with 6 polymorphisms was established: rs946961, rs943190 and rs8341 of the neuronal kinase gene PIP5KA2, rs7997012 of the serotonin receptor gene HTR2A, rs17326429 of the serotonin receptor gene HTR2C, rs3924999 of the NRG1 gene. The best sensitivity, specificity and AUC were obtained for the model including both genetic and non-genetic predictors (gender, age). Conclusion. The proposed medical technology can be used in practical healthcare to predict remission in patients with depressive disorders based on genotyping of DNA isolated from blood at baseline and for the targeted selection and implementation of individual therapeutic tactics in this category of patients.

 

Keywords: depression, genetics, remission, gene polymorphism, kinase system, neurotrophic system, serotonergic system.

 

Article (pdf)

 

Contacts

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Materials  

For citation: Vyalova N.M., Simutkin G.G., Ivanova S.A. Predicting the effectiveness of pharmacotherapy in patients with depressive disorders based on genetic parameters. Siberian Herald of Psychiatry and Addiction Psychiatry.2024; 3 (124): 28-35. https://doi.org/10.26617/1810-3111-2024-3(124)-28-35

 

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