Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
Neuropsychobiology. 2010 Aug;62(3):198-206. doi: 10.1159/000319362. Epub 2010 Jul 22.
Polymorphisms of serotonin transporter, especially serotonin transporter linked promoter region (5- HTTLPR) and serotonin transporter intron 2 variable number tandem repeat (5-HTTVNTR), have been suggested to be associated with treatment response to selective serotonin reuptake inhibitors. However, there have been only few reports of the association between 5-HTTLPR or 5-HTTVNTR and treatment response to venlafaxine.
84 Korean major depressive disorder patients were included in this study. They were administered 75 mg of venlafaxine XR (extended release) for 1 week and then took 150 mg for the next 3 weeks. All patients were evaluated at baseline and week 4 by the Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Beck Anxiety Inventory (BAI).
(1) Treatment response of depressive symptoms (BDI, HAM-D, MADRS) to venlafaxine at week 4 was associated with the non-s/s (l/l and l/s) genotype of 5-HTTLPR; (2) in repeated measures ANOVA, the BDI, MADRS and HAM-A scores decreased more significantly in patients with the non-s/s genotype than in those with the s/s genotype, and (3) multiple regression analyses suggested that the 5-HTTLPR polymorphism is a predictive factor for short-term treatment response to venlafaxine. However, 5-HTTVNTR showed no significant association with treatment response to venlafaxine. Both 5-HTTLPR and 5-HTTVNTR were not associated with side effects of venlafaxine.
The 5-HTTLPR non-s/s genotype can be associated with venlafaxine treatment responses. However, further large-scale studies are warranted to confirm this finding.
5-羟色胺转运体（5-HTT）的多态性，尤其是 5-羟色胺转运体启动子区（5-HTTLPR）和 5-羟色胺转运体内含子 2 可变数串联重复（5-HTTVNTR），被认为与选择性 5-羟色胺再摄取抑制剂（SSRIs）的治疗反应有关。然而，仅有少数报道涉及 5-HTTLPR 或 5-HTTVNTR 与文拉法辛治疗反应之间的关系。
本研究纳入 84 例韩国重度抑郁症患者。给予患者文拉法辛 XR（缓释片）75mg，1 周后增加至 150mg，持续 3 周。所有患者在基线和第 4 周时分别接受汉密尔顿抑郁量表（HAM-D）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、贝克抑郁自评量表（BDI）、汉密尔顿焦虑量表（HAM-A）和贝克焦虑自评量表（BAI）评估。
（1）第 4 周时，文拉法辛治疗抑郁症状（BDI、HAM-D、MADRS）的反应与 5-HTTLPR 的非 s/s（l/l 和 l/s）基因型有关；（2）重复测量方差分析显示，非 s/s 基因型患者的 BDI、MADRS 和 HAM-A 评分下降更为显著，（3）多元回归分析表明，5-HTTLPR 多态性是文拉法辛短期治疗反应的预测因素。然而，5-HTTVNTR 与文拉法辛的治疗反应无显著相关性。5-HTTLPR 和 5-HTTVNTR 均与文拉法辛的副作用无关。
5-HTTLPR 的非 s/s 基因型与文拉法辛的治疗反应有关。然而，需要进一步的大规模研究来证实这一发现。
