Journal article
Serotonin transporter gene promotor polymorphism (5-HTTLPR) associations with number of psychotropic medication trials in a tertiary care outpatient psychiatric consultation practice
Psychosomatics (Washington, D.C.), Vol.52(2), pp.147-153
03/2011
DOI: 10.1016/j.psym.2010.12.013
PMID: 21397107
Abstract
The authors tested the hypothesis that the short allele of 5-HTTLPR is associated with number of psychotropic medication trials as a measure of treatment-resistance or intolerance in psychosomatic medicine (PM) outpatients.
Review of Mayo Clinic PM outpatient 2008 records identified 44 (20.6%) who had 5-HTTLPR genotype tests. A univariate analysis screened for factors that could account for number of medication trials. Logistic regression then determined degree of association between 5-HTTLPR genotype category and number of pharmacological trials.
Univariate analysis revealed significant differences across the ordinal genotype spectrum long/long, short/long, short/short in mean number of overall psychotropic medication trials (8.9, 14.8, 18.0, P = 0.002), mean number of antidepressant trials (4.3, 7.2, 8.1, P = 0.018), mean number of mood stabilizer trials (0.8, 1.9, 2.3, P = 0.008), percent living alone (7%, 25%, 50%, P = 0.020), reported family history of depression (93%, 65%, 40%, P = 0.006), and reported family history of chemical dependency treatment (50%, 35%, 10%, P = 0.050). There were trends for differences in consultation reason for unexplained symptoms (14%, 25%, 50%, P = 0.063), and diagnoses of somatoform disorder (7%, 30%, 40%, P = 0.060), and generalized anxiety disorder (43%, 65%, 80%, P = 0.064). After controlling for other differences, presence of the short allele remained associated with number of psychotropic medication trials (OR 4.779, 95% CI 2.263-6.771, P = 0.004), and number of antidepressant trials (OR 1.591, 95% CI 1.072-2.762, P = 0.019).
5-HTTLPR testing may identify PM outpatients at higher relative risk for pharmacotherapy treatment non-response or intolerance who may benefit from alternative or augmentative medication recommendations or non-pharmacological interventions.
Details
- Title: Subtitle
- Serotonin transporter gene promotor polymorphism (5-HTTLPR) associations with number of psychotropic medication trials in a tertiary care outpatient psychiatric consultation practice
- Creators
- James R Rundell - Dept. of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. rundell.james@mayo.eduJeffrey P StaabGen ShinozakiDonald McAlpine
- Resource Type
- Journal article
- Publication Details
- Psychosomatics (Washington, D.C.), Vol.52(2), pp.147-153
- Publisher
- England
- DOI
- 10.1016/j.psym.2010.12.013
- PMID
- 21397107
- ISSN
- 0033-3182
- eISSN
- 1545-7206
- Language
- English
- Date published
- 03/2011
- Academic Unit
- Psychiatry; Anesthesia; Neurosurgery
- Record Identifier
- 9984003919602771
Metrics
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