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Correlation between cytochrome P450 2C19 genetic polymorphism and treatment response to escitalopram in panic
Qianqian He1, Zhuo Yuan, Yuanyuan Liu
1aTianjin Anding Hospital bTianjin Medical University cFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine dTianjin Chest Hospital, Tianjin, People's Republic of China eDepartment of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Objectives:
Escitalopram (S-CT) is used widely to treat patients with panic disorder (PD) and the CYP2C19 enzyme is responsible for S-CT metabolism. We hypothesized that CYP2C19 polymorphisms were associated with S-CT treatment response in Chinese patients with PD.
Patients And Methods:
Seventy-eight patients with PD completed the assessment by the Panic Disorder Severity Scale - Chinese Version (PDSS-CV) and the Hamilton Anxiety Scale (HAMA-14) during an 8-week period. All patients were administered a fixed dose of 10 mg/day S-CT. Three CYP2C19 metabolizer phenotypes were analyzed by PCR-genotyping microarray, including extensive metabolizer (EM), intermediate metabolizer, and poor metabolizer (PM).
Results:
This prospective, open-label and observational study showed that the proportion of EM (43.6%) was higher than that of PM (10.2%). There were higher response ratios of PDSS-CV in PM (the second to fourth week: 62.5-100%) than in EM (the second to fourth week: 23.5-55.9%) (Ps<0.05); also, there were higher response ratios of HAMA-14 in PM (the second to fourth week: 75.0-100%) than in EM (the second to fourth week: 17.7-52.9%) (Ps<0.05). Treatment response was based on the reduction of PDSS-CV and HAMA compared with the baseline. There was higher reduction of PDSS-CV in the patients with PM (68.78±9.04 for the fourth week and 84.30±9.81 for the eighth week) than EM (49.66±20.77 for the fourth week and 63.12±22.60 for the eighth week) (Ps<0.05); also, there was higher reduction of HAMA-14 in the patients with PM (70.11±8.98 for the fourth week and 81.32±8.25 for the eighth week) than EM (51.51±18.53 for the fourth week and 62.79±18.28 for the eighth week) (Ps<0.05).
Conclusion:
The CYP2C19 genetic polymorphism is associated with S-CT treatment response in Chinese patients with PD. CYP2C19 PM could play a key role in early treatment response of S-CT.
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