Markant Amelie, Tabrizi Fara, Grönvall Hampus, Speed Doug, Åhs Fredrik
Department of Psychology, University of Bremen, Bremen, Germany.
Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden.
Biol Psychiatry Glob Open Sci. 2025 Feb 18;5(3):100470. doi: 10.1016/j.bpsgos.2025.100470. eCollection 2025 May.
Anxiety and depression are the most prevalent mental health disorders. The first-line treatment is antidepressants, such as serotonin reuptake inhibitors, but benzodiazepines and antihistamines are also used to treat anxiety. Only one-third of patients achieve remission with first-line treatment. Identifying responders and nonresponders to monotherapy prior to treatment could increase remission rates and reduce dropout. The aim of the current study was to predict response to antidepressants, benzodiazepines, and antihistamines from polygenic risk scores (PRSs) in individuals with anxiety and/or depression symptoms.
We identified 2515 individuals in a genotyped cohort in the Swedish Twin Registry who had been prescribed drugs for anxiety and/or depression. Of these individuals, 1037 received monotherapy (555 with antidepressants, 169 with benzodiazepines, and 313 with antihistamines). The remaining 1478 individuals switched or added more drugs during the assessment period (2005-2018). The accuracy of 42 PRSs for psychiatric diagnoses as well as for nonclinical phenotypes in predicting mono- versus multitherapy was assessed using logistic regression.
Monotherapy with benzodiazepines was predicted by a PRS for depressive symptoms indexed by the Patient Health Questionnaire (odds ratio [OR] = 1.29), while monotherapy with antihistamines was predicted by a PRS for lifetime anxiety disorder (OR = 1.25) and a PRS for schizophrenia (OR = 1.24). None of the investigated PRSs significantly predicted monotherapy with antidepressants.
Real-world data suggest that monotherapy with benzodiazepines or antihistamines can be predicted from PRSs related to anxiety, depression, and schizophrenia.
焦虑症和抑郁症是最常见的心理健康障碍。一线治疗方法是使用抗抑郁药，如5-羟色胺再摄取抑制剂，但苯二氮䓬类药物和抗组胺药也用于治疗焦虑症。只有三分之一的患者通过一线治疗实现缓解。在治疗前识别对单一疗法有反应者和无反应者可提高缓解率并减少退出治疗的情况。本研究的目的是根据焦虑和/或抑郁症状个体的多基因风险评分（PRS）预测其对抗抑郁药、苯二氮䓬类药物和抗组胺药的反应。
我们在瑞典双胞胎登记处的一个基因分型队列中识别出2515名曾被开具治疗焦虑和/或抑郁药物的个体。在这些个体中，1037人接受单一疗法（555人使用抗抑郁药，169人使用苯二氮䓬类药物，313人使用抗组胺药）。其余1478人在评估期（2005 - 2018年）内更换或添加了更多药物。使用逻辑回归评估了用于精神疾病诊断以及非临床表型的42个PRS在预测单一疗法与多药联合疗法方面的准确性。
由患者健康问卷索引的抑郁症状PRS可预测使用苯二氮䓬类药物的单一疗法（优势比[OR]=1.29），而终生焦虑症PRS和精神分裂症PRS可预测使用抗组胺药的单一疗法（OR分别为1.25和1.24）。所研究的PRS均未显著预测使用抗抑郁药的单一疗法。
真实世界数据表明，可根据与焦虑症、抑郁症和精神分裂症相关的PRS预测使用苯二氮䓬类药物或抗组胺药的单一疗法。
