Response to Psychosocial Treatment in Poststroke Depression Is Associated With Serotonin Transporter Polymorphisms

• Published in: Stroke (1970) 2011-07, Vol.42 (7), p.2068-2070
• Main Authors: KOHEN, Ruth, CAIN, Kevin C, BUZAITIS, Ann, JOHNSON, Vicki, BECKER, Kyra J, TERI, Linda, TIRSCHWELL, David L, VEITH, Richard C, MITCHELL, Pamela H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alleles; Biological and medical sciences; Cardiovascular system; Depression - complications; Female; Genotype; Humans; Male; Medical sciences; Middle Aged; Neurology; Pharmacology. Drug treatments; Polymorphism, Genetic; Psychotherapy - methods; Serotonin Plasma Membrane Transport Proteins - genetics; Stroke - complications; Stroke - psychology; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Vasodilator agents. Cerebral vasodilators
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.110.611434

The Living Well With Stroke study has demonstrated effectiveness of a brief psychosocial treatment in reducing depressive symptoms after stroke. The purpose of this analysis was to determine whether key variables associated with prevalence of poststroke depression also predicted treatment response. Response to a brief psychosocial/behavioral intervention for poststroke depression was measured with the Hamilton Rating Scale for Depression. Analysis of covariance models tested for interaction of potential predictor variables with treatment group on percent change in Hamilton Rating Scale for Depression from pre- to post-treatment as an outcome. Initial depression severity, hemispheric location, level of social support, age, gender, and antidepressant adherence did not interact with the treatment with respect to percent change in Hamilton Rating Scale for Depression when considered 1 at a time. Participants who carried 1 or 2 s-alleles at the 5-HTTLPR serotonin transporterpolymorphism or 1 or 2 9- or 12-repeats of the STin2 VNTR polymorphism had significantly better response to psychosocial treatment than those with no s-alleles or no 9- or 12-repeats. Opposite to the effects of antidepressant drug treatment with selective serotonin reuptake inhibitors, the Living Well With Stroke psychotherapy intervention was most effective in 5-HTTLPR s-allele carriers and STin2VNTR 9- or 12-repeat carriers. URL: www.clinicaltrials.gov/ct/show/NCT00194454?order_1. Unique identifier: NCT00194454.