Factors affecting fluvoxamine antidepressant activity: Influence of pindolol and 5-HTTLPR in delusional and nondelusional depression

Raffaella Zanardi, Alessandro Serretti, David Rossini, Linda Franchini, Cristina Cusin, Enrico Lattuada, Danilo Dotoli, Enrico Smeraldi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It has been recently reported that the short variant of the serotonin transporter (5-HTT) gene-linked functional polymorphic region (5-HTTLPR) influences the antidepressant response to certain selective serotonin reuptake inhibitors. The aim of the present study was to test this finding in a sample of major and bipolar depressives, with or without psychotic features. Methods: One hundred fifty-five inpatients were treated with fluvoxamine 300 mg and either placebo or pindolol in a double-blind design for 6 weeks. The severity of depressive symptoms was weekly assessed with the Hamilton Rating Scale for Depression. Allelic variation of 5-HTTLPR in each subject was determined using a polymerase chain reaction-based technique. Results: 5-HTTLPR short variant was associated with a poor response to fluvoxamine treatment, independently from the recorded clinical variables. More specifically, the diagnosis, the presence of psychotic features, and the severity of depressive symptomatology did not influence this association. Conversely, pindolol augmentation may ameliorate the rate of response in 5-HTTLPR short variant subjects, thus reducing the difference in the response rate among the genotype variants. Conclusions: If confirmed, these results may improve patient care by helping the clinician to individualize treatment according to the patient's genetic 5-HTTLPR pattern.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalBiological Psychiatry
Volume50
Issue number5
DOIs
Publication statusPublished - Sep 1 2001

Keywords

  • Depression
  • Fluvoxamine
  • Pharmacogenetics
  • Pindolol
  • Serotonin transporter
  • Treatment response

ASJC Scopus subject areas

  • Biological Psychiatry

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