Genetic Predictors of Increase in Suicidal Ideation During Antidepressant Treatment in the GENDEP Project

The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escita...

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Published inNeuropsychopharmacology (New York, N.Y.) Vol. 34; no. 12; pp. 2517 - 2528
Main Authors Perroud, Nader, Aitchison, Katherine J, Uher, Rudolf, Smith, Rebecca, Huezo-Diaz, Patricia, Marusic, Andrej, Maier, Wolfgang, Mors, Ole, Placentino, Anna, Henigsberg, Neven, Rietschel, Marcella, Hauser, Joanna, Souery, Daniel, Kapelski, Pawel, Bonvicini, Cristian, Zobel, Astrid, Jorgensen, Lisbeth, Petrovic, Ana, Kalember, Petra, Schulze, Thomas G, Gupta, Bhanu, Gray, Joanna, Lewis, Cathryn M, Farmer, Anne E, McGuffin, Peter, Craig, Ian
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.11.2009
Nature Publishing Group
Subjects
Online AccessGet full text
ISSN0893-133X
1740-634X
1740-634X
DOI10.1038/npp.2009.81

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Abstract The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF , the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF ( p =0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2 , the gene encoding the BNDF receptor ( p =0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha 2A -adrenergic receptor gene ( ADRA2A ) ( p =0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.
AbstractList The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF, the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF (p=0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2, the gene encoding the BNDF receptor (p=0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha(2A)-adrenergic receptor gene (ADRA2A) (p=0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF, the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF (p=0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2, the gene encoding the BNDF receptor (p=0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha(2A)-adrenergic receptor gene (ADRA2A) (p=0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.
The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF, the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF (p=0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2, the gene encoding the BNDF receptor (p=0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha sub(2A)-adrenergic receptor gene (ADRA2A) (p=0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.
The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF , the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF ( p =0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2 , the gene encoding the BNDF receptor ( p =0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha 2A -adrenergic receptor gene ( ADRA2A ) ( p =0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.
The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor or a tricyclic antidepressant. A total of 796 adult patients with major depressive disorder who were treated with a flexible dosage of escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP) were included in the sample and provided data on suicidal ideation. Nine candidate genes involved in neurotrophic, serotonergic, and noradrenergic pathways were selected based on previous association studies with suicidal ideation or behavior. Using a logistic regression model, 123 polymorphisms in these genes were compared between subjects with an increase in suicidal ideation and those without any increase in suicidal ideation. Polymorphisms in BDNF, the gene encoding the brain-derived neurotrophic factor, were significantly associated with an increase in suicidal ideation. The strongest association was observed for rs962369 in BDNF (p=0.0015). Moreover, a significant interaction was found between variants in BDNF and NTRK2, the gene encoding the BNDF receptor (p=0.0003). Among men taking nortriptyline, suicidality was also associated with rs11195419 SNP in the alpha(2A)-adrenergic receptor gene (ADRA2A) (p=0.007). The associations observed with polymorphisms in BDNF suggest the involvement of the neurotrophic system in vulnerability to suicidality. Epistasis between BDNF and NTRK2 suggests that genetic variations in the two genes are involved in the same causal mechanisms leading to suicidality during antidepressant treatment. Among men, genetic variation in noradrenergic signaling may interact with norepinephrine reuptake-inhibiting antidepressants, thereby contributing to suicidality.
Author Farmer, Anne E
Petrovic, Ana
Craig, Ian
Jorgensen, Lisbeth
Kapelski, Pawel
Mors, Ole
Huezo-Diaz, Patricia
Placentino, Anna
Maier, Wolfgang
Rietschel, Marcella
Kalember, Petra
Zobel, Astrid
Gupta, Bhanu
Bonvicini, Cristian
Lewis, Cathryn M
Uher, Rudolf
Gray, Joanna
McGuffin, Peter
Hauser, Joanna
Marusic, Andrej
Perroud, Nader
Smith, Rebecca
Henigsberg, Neven
Schulze, Thomas G
Aitchison, Katherine J
Souery, Daniel
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  organization: MRC Social Genetic and Developmental Psychiatry Center, Institute of Psychiatry, King's College Lodon
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https://www.ncbi.nlm.nih.gov/pubmed/19641488$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright American College of Neuropsychopharmacology 2009
2009 INIST-CNRS
Copyright Nature Publishing Group Nov 2009
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Issue 12
Keywords norepinephrine
suicidal ideation
antidepressive agents
serotonin
BDNF
ADRA2A
Serotonin
Psychotropic
Catecholamine
Treatment
Neurotransmitter
Antidepressant agent
Genetics
Norepinephrine
Brain derived neurotrophic factor
Predictive factor
Suicide ideation
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PublicationSubtitle At the intersection of brain, behavior, and therapeutics
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PublicationYear 2009
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Nature Publishing Group
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Snippet The aim of this study was to investigate genetic predictors of an increase in suicidal ideation during treatment with a selective serotonin reuptake inhibitor...
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StartPage 2517
SubjectTerms Adult
Adult and adolescent clinical studies
Antidepressants
Antidepressive Agents - adverse effects
Antidepressive Agents - therapeutic use
Behavioral Sciences
Biological and medical sciences
Biological Psychology
Brain research
Brain-derived neurotrophic factor
Brain-Derived Neurotrophic Factor - genetics
Citalopram - adverse effects
Citalopram - therapeutic use
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - genetics
Female
Follow-Up Studies
Genes
Genetic Predisposition to Disease
Haplotypes
Humans
Linkage Disequilibrium
Logistic Models
Male
Medical sciences
Medicine
Medicine & Public Health
Mental depression
Neuropharmacology
Neurosciences
Nortriptyline - adverse effects
Nortriptyline - therapeutic use
original-article
Pharmacology. Drug treatments
Pharmacotherapy
Polymorphism, Genetic
Polymorphism, Single Nucleotide
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, trkB - genetics
Receptors, Adrenergic, alpha-2 - genetics
Serotonin
Sex Factors
Sociodemographics
Suicidal behavior
Suicide
Suicides & suicide attempts
Title Genetic Predictors of Increase in Suicidal Ideation During Antidepressant Treatment in the GENDEP Project
URI https://link.springer.com/article/10.1038/npp.2009.81
https://www.ncbi.nlm.nih.gov/pubmed/19641488
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Volume 34
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