Influence of 5-HTR2A genetic polymorphisms on the efficacy of antidepressants in the treatment of major depressive disorder: A meta-analysis

• Published in: Journal of affective disorders 2014-10, Vol.168, p.430-438
• Main Authors: Lin, Jian-Yang, Jiang, Ming-Yan, Kan, Zhou-Mi, Chu, Yang
• Format: Article
• Language: English
• Subjects: 5-HTR2A; Adult and adolescent clinical studies; Alleles; Antidepressive Agents - therapeutic use; Asian Continental Ancestry Group - genetics; Biological and medical sciences; Depression; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - genetics; Humans; Major depressive disorder; Medical sciences; Meta-analysis; Miscellaneous; Mood disorders; Neuropharmacology; Pharmacogenetics; Pharmacology. Drug treatments; Polymorphism; Polymorphism, Genetic; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Receptor, Serotonin, 5-HT2A - genetics; Treatment Outcome
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2014.06.012

Abstract Objective The aim of the current meta-analysis was to assess the influence of common genetic polymorphisms in the 5-HTR2A gene on the efficacy of antidepressants in the treatment of major depressive disorder (MDD). Method MEDLINE (1966–2013), Cochrane Library Database (Issue 12, 2013), EMBASE (1980–2013), CINAHL (1982–2013), Web of Science (1945–2013) and Chinese Biomedical Database (CBM) (1982–2013) were searched without language restrictions. Meta-analysis was performed using the STATA statistical software. We calculated the odds ratio (OR) and its 95% confidence interval (95% CI) to estimate the efficacy of antidepressants in the treatment of MDD. Results Eleven studies with a total of 1775 MDD patients met the inclusion criteria of this meta-analysis. Three common polymorphisms in the 5-HTR2A gene were assessed, including rs6311 C>T, rs7997012 G>A, and rs6313 T>C. Our findings suggested that the 5-HTR2A rs6313 T>C polymorphism was significantly correlated with a higher response rate to antidepressants in MDD patients (allele model: OR=1.33, 95% CI=1.05–1.68, P =0.020; dominant model: OR=1.62, 95% CI=1.21–2.18, P =0.001; homozygous model: OR=1.85, 95% CI=1.18–2.90, P =0.008). The rs7997012 G>A polymorphism was also associated with a higher response rate to antidepressants in MDD patients under the dominant model (OR=1.92, 95% CI=1.02–3.61, P =0.044). However, no significant correlation was found for the 5-HTR2A rs6311 C>T polymorphism under five genetic models (all P >0.05). Conclusion Our findings provide empirical evidence that the 5-HTR2A rs6313 T>C and rs7997012 G>A polymorphism may be correlated with the efficacy of antidepressants in the treatment of MDD.