TABLE 1.
Antidepressant Drug-by-Gene Associations With Moderate to High Levels of Evidence or Included in One of the Combinatorial Pharmacogenetic Tests Evaluated Herea
| Pharmacodynamic |
Pharmacokinetic |
||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Agent | ADRA2A | BDNF | COMT | CRHR1 | FKBP5 | GRIK4 | HTR1A | HTR2A | SLC6A2 | SLC6A4 | ABCB1 | CYP1A2 | CYP2B6 | CYP2C19 | CYP2D6 |
| Amitriptylineb | 3 | 1A | |||||||||||||
| Bupropion | |||||||||||||||
| Citalopramb | 3 | 2B | 2B | 2A | 3 | 1A | 3 | ||||||||
| Desipramineb | 3 | 1A | |||||||||||||
| Doxepinb | 1A | ||||||||||||||
| Duloxetineb | 3 | 3 | 2A | 1A | 1A | ||||||||||
| Escitalopramb | 3 | 3 | 2B | 3 | 3 | 3 | 3 | ||||||||
| Fluoxetineb | 3 | 3 | 3 | 3 | 3 | 1A | 3 | ||||||||
| Fluvoxamineb | 3 | 1A | |||||||||||||
| Imipramineb | 2A | 1A | |||||||||||||
| Maprotiline | 3 | ||||||||||||||
| Mirtazapine | 2B | 3 | 3 | ||||||||||||
| Nefazodoneb | 3 | 3 | |||||||||||||
| Nortriptylineb | 3 | 3 | 1A | ||||||||||||
| Paroxetineb | 3 | 3 | 2B | 3 | 3 | 3 | 3 | 1A | |||||||
| Sertraline | 3 | 3 | 3 | 1A | |||||||||||
| Trimipramineb | 1A | ||||||||||||||
| Venlafaxineb | 3 | 2B | 3 | 3 | 2A | ||||||||||
| Antidepressants, unspecified | 3 | 3 | 2B | 2B | 3 | 2B | 3 | 1A | |||||||
| SSRIs, unspecified | 3 | 2B | 2B | 3 | 2B | 3 | |||||||||
| Number of variants per gene | 1 | 6 | 2 | 2 | 4 | 2 | 3 | 5 | 1 | 3 | 15 | 9 | 5 | 8 | 14 |
| Interaction typec | E | E,T | E | E | E,T | E | E | E,T | E | E,T | E,T | E,T | E,O | E,M,T | E,D,M,T |
This is not a comprehensive representation of antidepressant drug-by-gene associations; it is limited to the PharmGKB search terms “depressive disorder, major; depressive disorder;depression;[antidepressant name]”; it excludes drug-gene interactions related to “bipolar disorder;anxiety disorder”; it excludes antipsychotic and some antidepressant drugs;and it excludes many drug-gene associations for which low/preliminary (level 3/4) evidence exists, as defined by PharmGKB. The PharmGKB knowledge base, which was used to generate this table, is not the sole source of relevant pharmacogenetic information. BDNF= brain-derived neurotrophic factor;COMT=catechol O-methyltransferase;SSRI=selective serotonin reuptake inhibitor.
These agents have U.S. Food and Drug Administration labeling with CYP450 pharmacogenetic information.
Pharmacogenetic information relevant to drug efficacy (E), dosage (D), metabolism/pharmacokinetics (M), toxicity/adverse drug reactions (T), and other (O). Values correspond to a high (1A, 1B), moderate (2A, 2B), or low (3) level of evidence according to the PharmGKB rating scale.