Tailored Antidepressantsby Karen Vieira, MBA, PhD | December 31, 2007
As the field of genetics advances it is likely that treatment with antidepressants will be tailored to your personal genes. A study published by the National Institute of Mental Health in the American Journal of Psychiatry states that certain genetic markers directly corresponded to an increased risk of suicide in adults suffering from depression who were treated with citalopram, an antidepressant drug. This is only one of many of discoveries to come that will aid in the treatment of depression.
The above-mentioned study found two genetic markers called GRIA3 and GRIA2 directly involved with significant increases in suicidal tendencies in patients taking antidepressants, specifically SSRIs to treat depression. These genes are glutamate receptors and are involved in memory and learning. A variation in the DNA of these markers is what makes the difference from one patient to the next. For those who carry only one marker, GRIA3, had nearly a doubled risk and patients who carried only the GRIA2 marker were eight times more likely to have suicidal thoughts. In patients who carried both genes the results were remarkable. These participants showed an increased risk almost fifteen times higher than people who carry neither marker. There is only a small chance of anyone carrying both DNA variations but it is still noteworthy. It is the hope of the researchers that this information will lead to better screening to ensure that depression sufferers with one or both of these markers is treated with a different class of antidepressants or are educated on the risk and monitored. The potential for these types of studies are very exciting and as more genetic markers are identified it is likely that all different types of medical or mental health treatment will be tailored to the genetic make up of each individual.
We do not choose our genetic makeup and if part of that makeup is a propensity for depression that requires medical intervention it is comforting to know that these kinks are being worked out. As more studies look into depression and antidepressant treatment we will soon see a time when the genetics of depression and mental health issues are better understood leading to more safe and effective treatment. This field of study will eventually play a part in the diagnosis and treatment plan of all kinds of diseases. We can look forward to a steady stream of studies and findings that will change the way we are diagnosed and treated.
Laje G, Paddock S, Manji H, et al. Genetic markers of suicidal ideation emerging during citalopram treatment of major depression. Am J Psychiatry. 2007;164(10):1530-1538
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