Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Department of Clinical Pharmacology, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Int J Mol Sci. 2023 Aug 30;24(17):13459. doi: 10.3390/ijms241713459.
Depression is a global mental health concern, and personalized treatment approaches are needed to optimize its management. This study aimed to investigate the influence of the CYP2D6 and CYP1A2 gene polymorphisms on the efficacy of duloxetine in reducing depressive and anxiety symptoms. A sample of 100 outpatients with major depression, who initiated monotherapy with duloxetine, were followed up. Polymorphisms in the CYP2D6 and CYP1A2 genes were assessed. The severity of depressive and anxiety symptoms was recorded using standardized scales. Adverse drug reactions (ADRs) were analyzed. Statistical analyses, including linear regression, were conducted to examine the relationships between genetic polymorphisms, clinical variables, and treatment outcomes. Patients with higher values of the duloxetine metabolic index (DMI) for CYP2D6, indicating a faster metabolism, achieved a greater reduction in anxiety symptoms. The occurrence of ADRs was associated with a lower reduction in anxiety symptoms. However, no significant associations were found between studied gene polymorphisms and reduction in depressive symptoms. No significant effects of the DMI for CYP1A2 were found. Patients with a slower metabolism may experience less benefit from duloxetine therapy in terms of anxiety symptom reduction. Personalizing treatment based on the CYP2D6 and CYP1A2 gene polymorphisms can enhance the effectiveness of antidepressant therapy and improve patient outcomes.
抑郁症是一种全球性的心理健康问题，需要采用个性化的治疗方法来优化其管理。本研究旨在探讨 CYP2D6 和 CYP1A2 基因多态性对度洛西汀降低抑郁和焦虑症状疗效的影响。我们对 100 名开始接受度洛西汀单药治疗的重度抑郁症门诊患者进行了随访。评估了 CYP2D6 和 CYP1A2 基因的多态性。使用标准化量表记录抑郁和焦虑症状的严重程度。分析了药物不良反应（ADR）。进行了统计分析，包括线性回归，以检查基因多态性、临床变量和治疗结果之间的关系。CYP2D6 代谢指数（DMI）较高的患者，表明代谢更快，焦虑症状的减轻程度更大。ADR 的发生与焦虑症状减轻程度较低相关。然而，研究的基因多态性与抑郁症状减轻之间没有发现显著关联。CYP1A2 的 DMI 没有显著影响。代谢较慢的患者可能在焦虑症状减轻方面从度洛西汀治疗中获益较少。基于 CYP2D6 和 CYP1A2 基因多态性的个体化治疗可以增强抗抑郁治疗的效果并改善患者的预后。
