The apolipoprotein E ε4 allele and antidepressant efficacy in cognitively intact elderly depressed patients

Murphy, Greer M.; Kremer, C.M.E.; Rodrigues, H.; Schatzberg, Alan F.

doi:10.1016/s0006-3223(03)00174-4

Cited by 38 publications

(24 citation statements)

References 41 publications

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“…These results were confirmed in two 8-week, double-blind, randomized controlled trials by Schatzberg et al 2002 and Murphy et al 2003 9,10 which included patients from US aged at least 65 years old. They were treated in the outpatient setting.…”

Section: Resultsmentioning

confidence: 70%

Efficacy and Tolerability of Mirtazapine versus Paroxetine in the Treatment of Major Depressive Disorder

Rodriguez

Ferrer

Odriozola

2012

Clinical Medicine Insights: Therapeutics

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Objective: To compare the efficacy and tolerability of paroxetine and mirtazapine in the treatment of major depression. Data sources: Searches were conducted to identify studies through Medline (1980-2011), PsycInfo (1980-2011 and PubMed databases up to June 2011. The searches were not restricted to publication type or clinical trial design. Study selection: A clinical trial was included if it described a trial of paroxetine versus mirtazapine in patients with major depression, based on the research evidence of reviews. Data abstraction: Three assessors analyzed the quality of the trials and extracted study design data, trial features, efficacy and tolerability assessment tools, discontinuation reasons for both antidepressants and remitter and responder rates. Results: We included six randomized controlled trials, one open-label, randomized controlled trial and four systematic reviews and metaanalysis. Rates of remission and response between mirtazapine and paroxetine were compared: at the beginning (1-2 weeks) there were statistically significant differences in mirtazapine treated patients, but these were not found at the end of assessment period (6-8 weeks). Discontinuation rates between the two drugs showed no differences, with an adverse event profile characteristic of each drug. Conclusions: Mirtazapine and paroxetine were equally effective and well-tolerated in major depressive disorder. Differences in effectiveness were only observed in the first or second week of treatment when mirtazapine showed earlier onset of action.

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Section: Resultsmentioning

confidence: 70%

Efficacy and Tolerability of Mirtazapine versus Paroxetine in the Treatment of Major Depressive Disorder

Rodriguez

Ferrer

Odriozola

2012

Clinical Medicine Insights: Therapeutics

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“…Older patients with major depression generally have more medical comorbidities and worse prognosis (Cole and Bellavence, 1997;Cole et al, 1999). There were positive finding in elderly depression patient of antidepressant effects with APOE4 (Murphy et al, 2003). But, in this study, we excluded the cor-morbid medical disease cases in selection process and used APOE4 allele as covariates in regression analysis and there were no significant influence to total score of HRSD.…”

Section: Discussionmentioning

confidence: 91%

“…The most widely accepted theory states that certain genetic variations affect the normal functions of neurotransmitters by lowering serotonin and/or norepinephrine (NE) levels (Delgado and Kahn, 2002), causing dopamine deficiency, or reducing corticotrophin releasing factor binding sites, which in turn reduces the number of synaptic gaps of brain tissue and the speed of neurotransmissions. The protein structure of serotonin transporters, the genes regulating serotonin expression, and the apolipoprotein E (APOE) genotypes are being extensively tested for potential association with depression (Murphy et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

MAOA gene polymorphisms and response to mirtazapine in major depression

Tzeng

Chien

Lung

et al. 2009

Human Psychopharmacology

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“…Additionally, a recent study has shown the short allele of the serotonin transporter promoter polymorphism (SERTPR) to be associated with increased development of depression following stressful life events [Caspi et al, 2003], and a meta-analysis concluded that the same mutation was associated with suicidal behavior [Anguelova et al, 2003]. A recent study has also indicated that the apolipoprotein E (e4 allele (an established risk factor for Alzhiemer's disease) was associated with response to paroxetine in an elderly population [Murphy et al, 2003b]. Finally, considering the amount of research examining the association between innumerable diseases and a variety of genetic variants, it is virtually assured that new diseases and behaviors will be found to be associated with CYP2D6, SERTPR, and other gene polymorphisms involved in SSRI action in the future.…”

Section: Ethical and Practical Considerationsmentioning

confidence: 99%

Genetic screening for SSRI drug response among those with major depression: great promise and unseen perils

Rasmussen‐Torvik

McAlpine

2007

Depress. Anxiety

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This article examines evidence for the potential benefit of genetic testing for SSRI response, as well as potential ethical and practical implications of the implementation of this test into standard psychiatric practice. We reviewed three areas of the literature: the burden of treatment-resistant and treatment-intolerant major depressive disorders, the evidence for the value of genetic testing to predict drug response, and the ethical and practical issues of genetic testing in usual care. Treatment resistance and treatment intolerance are common for persons treated with selective serotonin reuptake inhibitors (SSRIs) and are associated with both financial and quality-of-life costs. There is strong evidence from association studies that some polymorphisms are associated with SSRI response. However, no randomized trials have yet tested the efficacy of genetic tests to improve outcome in those with treatment resistance or treatment intolerance to SSRIs. Given the nonspecific nature of the test proposed, several ethical concerns are also involved with administering the genetic tests to patients. A randomized trial comparing response in those treated with standard psychiatric care and in those treated with psychiatric care tailored as a result of genetic test results should be completed before the implementation of these tests can be considered. Additionally, the ethical and practical questions concerning the tests must be addressed now, so that the potential impact of these tests on patient care can be well understood prior to adoption in standard practice.

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The apolipoprotein E ε4 allele and antidepressant efficacy in cognitively intact elderly depressed patients

Cited by 38 publications

References 41 publications

Efficacy and Tolerability of Mirtazapine versus Paroxetine in the Treatment of Major Depressive Disorder

Efficacy and Tolerability of Mirtazapine versus Paroxetine in the Treatment of Major Depressive Disorder

MAOA gene polymorphisms and response to mirtazapine in major depression

Genetic screening for SSRI drug response among those with major depression: great promise and unseen perils

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