Pharmacogenomic study of side-effects for antidepressant treatment options in STAR*D

Psychol Med. 2012 Jun;42(6):1151-62. doi: 10.1017/S003329171100239X. Epub 2011 Nov 1.

Abstract

Background: Understanding individual differences in susceptibility to antidepressant therapy side-effects is essential to optimize the treatment of depression.

Method: We performed genome-wide association studies (GWAS) to search for genetic variation affecting the susceptibility to side-effects. The analysis sample consisted of 1439 depression patients, successfully genotyped for 421K single nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Outcomes included four indicators of side-effects: general side-effect burden, sexual side-effects, dizziness and vision/hearing-related side-effects. Our criterion for genome-wide significance was a prespecified threshold ensuring that, on average, only 10% of the significant findings are false discoveries.

Results: Thirty-four SNPs satisfied this criterion. The top finding indicated that 10 SNPs in SACM1L mediated the effects of bupropion on sexual side-effects (p = 4.98 × 10(-7), q = 0.023). Suggestive findings were also found for SNPs in MAGI2, DTWD1, WDFY4 and CHL1.

Conclusions: Although our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that could mediate adverse effects of antidepressant medication.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Bupropion / adverse effects
  • Citalopram / adverse effects
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / genetics*
  • Drug-Related Side Effects and Adverse Reactions / classification
  • Drug-Related Side Effects and Adverse Reactions / genetics*
  • Factor Analysis, Statistical
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study
  • Humans
  • Linear Models
  • Linkage Disequilibrium / genetics
  • Membrane Proteins / genetics
  • Membrane Proteins / physiology
  • Pharmacogenetics
  • Phenotype
  • Polymorphism, Single Nucleotide / genetics*
  • Sexual Dysfunction, Physiological / chemically induced
  • Sexual Dysfunction, Physiological / genetics
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Membrane Proteins
  • Bupropion
  • Citalopram
  • SACM1L protein, human