Putzhammer Albert, Schoeler Anja, Rohrmeier Thomas, Sand Philipp, Hajak Goeran, Eichhammer Peter
Department of Psychiatry, University of Regensburg, 93042 Regensburg, Germany.
Psychopharmacology (Berl). 2005 Mar;178(2-3):303-8. doi: 10.1007/s00213-004-1995-3. Epub 2004 Aug 18.
Serotonergic mechanisms are thought to play an important role in the regulation of mood, motor activity and sleep patterns. Serotonin reuptake is controlled by the serotonin transporter (5-HTT) and by a common functional insertion/deletion polymorphism in the corresponding gene's promoter region (5-HTTLPR). Homozygosity for the long variant may confer a favourable response to treatment with serotonin reuptake inhibitors (SSRIs), and to sleep deprivation.
The study assessed the role of the 5-HTTLPR genotype in determining motor side effects of antidepressant medication.
Motor activity patterns of 62 patients with major depression who were being treated with either SSRIs or tricyclic antidepressants (TCAs) were monitored over a 24-h period using a wrist-actograph. Additionally, motor activity was rated in a semi-structured interview using the motor agitation and retardation scale (MARS).
Night-time motor activity was significantly increased in homozygous carriers of the long 5-HTTLPR allele (LL-genotype) who were being treated with SSRIs in comparison to short allele carriers (LS-genotype and SS-genotype), regardless of the type of antidepressant treatment (P<0.001). It was also significantly increased in comparison to patients with the LL-genotype who were being treated with TCAs (P<0.01). Differences in actographic motor activity were most prominent between 11 p.m. and 4 a.m. Clinical ratings of motor activity also showed a trend toward higher agitation scores in patients with the LL-genotype who received SSRI treatment.
Homozygosity for the long variant of the 5-HTTLPR may cause a predisposition to increased night-time motor activity in conjunction with SSRI treatment.
血清素能机制被认为在情绪、运动活动和睡眠模式的调节中起重要作用。血清素再摄取由血清素转运体（5-HTT）以及相应基因启动子区域的一个常见功能性插入/缺失多态性（5-HTTLPR）控制。长变体纯合子可能对血清素再摄取抑制剂（SSRI）治疗以及睡眠剥夺产生良好反应。
本研究评估5-HTTLPR基因型在确定抗抑郁药物运动副作用方面的作用。
使用腕部活动记录仪在24小时内监测62例正在接受SSRI或三环类抗抑郁药（TCA）治疗的重度抑郁症患者的运动活动模式。此外，在半结构化访谈中使用运动激越和迟缓量表（MARS）对运动活动进行评分。
与短等位基因携带者（LS基因型和SS基因型）相比，接受SSRI治疗的长5-HTTLPR等位基因纯合携带者（LL基因型）夜间运动活动显著增加，无论抗抑郁治疗类型如何（P<0.001）。与接受TCA治疗的LL基因型患者相比，其夜间运动活动也显著增加（P<0.01）。活动记录仪记录的运动活动差异在晚上11点至凌晨4点最为明显。运动活动的临床评分也显示，接受SSRI治疗的LL基因型患者的激越评分有升高趋势。
5-HTTLPR长变体纯合子可能与SSRI治疗一起导致夜间运动活动增加的易感性。
