Antidepressants: Better effect thanks to genetic analysis
Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.Modern antidepressants are a blessing for many depressed people. Unfortunately, however, the drugs do not work well in every patient. A genetic analysis could help to dose them more precisely.
When drugs don't work properly, the cause may be in the patient's genes. This also applies to modern antidepressants such as escitalopram, which is one of the so-called serotonin reuptake inhibitors (SSRI).
Scientists from the Karolinska Institute in Stockholm have found that special variants of the CYP2C19 gene influence the effect of the drugs. Because the gene provides the blueprint for an enzyme that breaks down escitalopram in the body.
Gene variants influence the breakdown of active substances
People with certain variants of the gene produce larger amounts of the enzyme than usual. As a result, the antidepressant agent breaks down too quickly in your body and cannot work.
Other genetic variants, on the other hand, apparently result in reduced enzyme production. The level of the active substance is then too high in the patients, so that they suffer from severe side effects. These include nausea and diarrhea, insomnia and sexual dysfunction.
These genetic variants are not uncommon: of the more than 2000 study participants examined by the team led by study leader Prof. Magnus Ingelman-Sundberg, at least one third had either too high or too low an active ingredient level of escitalopram.
More precise dosing
"By typing the CYP2C19 gene, one could dose escitalopram more precisely and thus achieve a better antidepressant effect," says Ingelman-Sundberg. Overdose-related side effects could also be avoided. Since CYP2C19 also plays a central role in the metabolism of other SSRIs, such a procedure can also be useful when prescribing other drugs.
This is how SSRIs work
SSRIs have been a fixture in the treatment of depression since the 1980s. The active ingredients increase the level of serotonin in the brain. Serotonin is a messenger substance that is used, among other things, for communication between nerve cells. In the brain, it has a mood-enhancing, anxiety-relieving and activating effect. If its recovery is slowed down, it accumulates in the brain.
