Aoki Akiko, Ishiguro Shin, Watanabe Takashi, Ueda Mikito, Hayashi Yuki, Akiyama Kazufumi, Kato Kazuko, Inoue Yoshimasa, Tsuchimine Shoko, Yasui-Furukori Norio, Shimoda Kazutaka
Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan.
Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Tochigi, Japan.
Neuropsychiatr Dis Treat. 2014 Sep 18;10:1793-8. doi: 10.2147/NDT.S68670. eCollection 2014.
The aims of the present study were to analyze the association between discontinuation of paroxetine (PAX) and the genetic variants of the polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in Japanese patients with panic disorder (PD) and major depressive disorder (MDD).
The 5-HTTLPR genotype was determined by polymerase chain reaction method. PAX plasma concentration was measured by high-performance liquid chromatography to confirm adherence.
When comparing between the PD and MDD patients with the chi-square test and Fisher's exact test, the PD patients had a significant and higher discontinuation rate due to non-adherence than did the MDD patients (13.5% [7/52] versus 0% [0/88], respectively; P<0.001). MDD patients had a significant and higher discontinuation rate due to untraceability than PD patients (12.5% [11/88] versus 1.9% [1/52]; P=0.032). Multilogistic regression revealed a tendency for the long/short and short/short genotypes to affect discontinuation due to adverse effects in PD patients (25.0% versus 6.3%, respectively; P=0.054).
The results indicate that the 5-HTTLPR genotype might contribute to the discontinuation of initial PAX treatment due to adverse effects in PD patients.
本研究旨在分析日本惊恐障碍（PD）和重度抑郁症（MDD）患者中帕罗西汀（PAX）停药与血清素转运体基因连锁多态性区域（5-HTTLPR）多态性基因变异之间的关联。
采用聚合酶链反应法测定5-HTTLPR基因型。通过高效液相色谱法测量PAX血浆浓度以确认依从性。
在采用卡方检验和费舍尔精确检验对PD和MDD患者进行比较时，PD患者因不依从导致的停药率显著高于MDD患者（分别为13.5%[7/52]和0%[0/88]；P<0.001）。MDD患者因无法追踪导致的停药率显著高于PD患者（12.5%[11/88]和1.9%[1/52]；P=0.032）。多因素逻辑回归显示，长/短和短/短基因型在PD患者中因不良反应影响停药存在一种趋势（分别为25.0%和6.3%；P=0.054）。
结果表明，5-HTTLPR基因型可能导致PD患者因不良反应而停用初始PAX治疗。
