Smits Kim, Smits Luc, Peeters Frenk, Schouten Jan, Janssen Rob, Smeets Hubert, van Os Jim, Prins Martin
Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Int Clin Psychopharmacol. 2007 May;22(3):137-43. doi: 10.1097/YIC.0b013e328014822a.
During treatment with selective serotonin reuptake inhibitors, some patients experience adverse events whereas others do not. Assessment of predictors for selective serotonin reuptake inhibitors-induced adverse events would be useful for the identification of patients likely to develop these events. This study evaluates the association between adverse events during selective serotonin reuptake inhibitor treatment and two polymorphisms in the serotonin transporter (5-HTTLPR and STin2) gene. We included 214 patients meeting Diagnostic and statistical manual of mental disorder-IV criteria for major depression and using an selective serotonin reuptake inhibitor for at least 6 weeks. Blood samples or buccal swabs were taken to determine 5-HTTLPR and STin2 genotype. Information on adverse events was gathered through interviews and general practitioners' files. The association between serotonin transporter genotype and adverse events was assessed by use of logistic regression. Patients with the 5-HTTLPR s/s or s/l genotype appeared to have an increased risk of adverse events, especially general adverse events (dermatologic reactions, weight change and fatigue); odds ratio 1.77 (95% confidence interval 0.80-3.92) for the s/s genotype, odds ratio 2.37 (95% confidence interval 1.13-4.96) for the s/l genotype. For STin2, results were inconsistent and observed associations were weak and statistically nonsignificant. Our findings indicate that patients with the 5-HTTLPR s/s or s/l genotype have an increased risk of developing adverse events during selective serotonin reuptake inhibitor treatment.
在使用选择性5-羟色胺再摄取抑制剂进行治疗期间，一些患者会出现不良事件，而另一些患者则不会。评估选择性5-羟色胺再摄取抑制剂诱发不良事件的预测因素，对于识别可能发生这些事件的患者会很有帮助。本研究评估了选择性5-羟色胺再摄取抑制剂治疗期间不良事件与5-羟色胺转运体（5-HTTLPR和STin2）基因的两种多态性之间的关联。我们纳入了214例符合《精神疾病诊断与统计手册》第四版中重度抑郁症标准且使用选择性5-羟色胺再摄取抑制剂至少6周的患者。采集血样或口腔拭子以确定5-HTTLPR和STin2基因型。通过访谈和全科医生档案收集不良事件信息。使用逻辑回归评估5-羟色胺转运体基因型与不良事件之间的关联。5-HTTLPR s/s或s/l基因型的患者出现不良事件的风险似乎增加，尤其是一般不良事件（皮肤反应、体重变化和疲劳）；s/s基因型的优势比为1.77（95%置信区间0.80 - 3.92），s/l基因型的优势比为2.37（95%置信区间1.13 - 4.96）。对于STin2，结果不一致，观察到的关联较弱且无统计学意义。我们的研究结果表明，5-HTTLPR s/s或s/l基因型的患者在选择性5-羟色胺再摄取抑制剂治疗期间发生不良事件的风险增加。
