5-HTTLPR and >T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial.

BACKGROUND

There is growing evidence suggesting that both genetic and environmental factors modulate treatment outcome in, a highly heterogeneous, major depressive disorder (MDD). 5-HTTLPR variant of the serotonin transporter gene (SLC6A4) and >T polymorphisms have been linked to the pathogenesis of MDD, and antidepressant treatment response. The evidence is lacking on the clinical utility of yoga in patients with MDD who have 5-HTTLPR and >T polymorphisms and less likely to respond to medications (SSRIs).

AIMS

We aimed to examine the impact of YBLI in those who have susceptible 5-HTTLPR and >T polymorphisms and are less likely to drug therapy with SSRIs.

SETTINGS AND DESIGN

In a 12 week randomized active-controlled trial, MDD patients ( = 178) were randomized to receive YBLI or drug therapy.

METHODS

Genotyping was conducted using PCR-based methods. The clinical remission was defined as BDI-II score ≤ 9.

STATISTICAL ANALYSIS USED

An intent-to-treat analysis was performed, and the association of genotype with treatment remission consisted of the logistic regression model. A value of <0.05 was considered statistically significant.

RESULTS

Multivariate logistic regression models for remission including either 5-HTTLPR or >T genotypes showed statistically significant odds of remission in YOGA arm vs. DRUG arm. Neither 5-HTTLPR nor >T genotype showed any influence on remission to YBLI ( = 0.73 and = 0.64, respectively). Further analysis showed childhood adversity interact with 5-HTTLPR and >T polymorphisms to decrease treatment response in DRUG treatment arm, but not in YOGA arm.

CONCLUSIONS

YBLI provides MDD remission in those who have susceptible 5-HTTLPR and >T polymorphisms and are resistant to SSRIs treatment. YBLI may be therapeutic for MDD independent of heterogeneity in its etiopathogenesis.