Should a routine genotyping of CYP2D6 and CYP2C19 genetic polymorphisms be recommended to predict venlafaxine efficacy in depressed patients treated in psychiatric settings?

Pharmacogenomics. 2017 May;18(7):639-650. doi: 10.2217/pgs-2017-0003. Epub 2017 May 8.

Abstract

Aim: The antidepressant venlafaxine (VEN) is metabolized by CYP2D6 and CYP2C19. The aim of this study was to assess the relevance of generalizing to daily practice the genotyping of CYP2D6 and CYP2C19 to predict VEN efficacy in depressed patients treated in psychiatric settings.

Patients & methods: This study was nested in a naturalistic cohort, with 206 patients requiring a new antidepressant treatment and genotyped for CYP2D6 *3, *4, *5 del, *6, *2xN, *10, *41 and CYP2C19 *2, *3, *4, *5, *17 alleles.

Results: CYP2D6 and CYP2C19 phenotypes were associated neither with the Hamilton depression rating scale score improvement, nor with response and remission.

Conclusion: Routine CYP2D6 and CYP2C19 genotyping cannot be recommended to predict VEN efficacy in depressed patients treated in psychiatry settings.

Keywords: antidepressants; pharmacogenetics; venlafaxine.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Cohort Studies
  • Cytochrome P-450 CYP2C19 / genetics*
  • Cytochrome P-450 CYP2C19 / metabolism
  • Cytochrome P-450 CYP2D6 / genetics*
  • Cytochrome P-450 CYP2D6 / metabolism
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / genetics*
  • Depressive Disorder, Major / metabolism
  • Female
  • Follow-Up Studies
  • Genotype*
  • Humans
  • Male
  • Middle Aged
  • Polymorphism, Genetic / genetics
  • Predictive Value of Tests
  • Prospective Studies
  • Treatment Outcome
  • Venlafaxine Hydrochloride / metabolism
  • Venlafaxine Hydrochloride / therapeutic use*

Substances

  • Antidepressive Agents, Second-Generation
  • Venlafaxine Hydrochloride
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6