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CYP2C19 Genetic Variants and Major Depressive Disorder: A Systematic Review
Larissa Sousa Silva Bonasser1, Calliandra Maria de Souza Silva2, Caroline Ferreira Fratelli3
1Postgraduate Program in Health Sciences, University Campus Darcy Ribeiro, University of Brasília (UnB), Brasília-Federal District (DF), Brasília 70910-900, Brazil.
Pharmaceuticals (Basel, Switzerland)
|November 27, 2024
Summary
CYP2C19 gene variants influence antidepressant metabolism and major depressive disorder (MDD) treatment response. Frequencies vary globally, impacting clinical traits and drug efficacy, necessitating further research for personalized medicine.
Area of Science:
- Pharmacogenomics
- Neuroscience
- Genetics
Background:
- Major depressive disorder (MDD) affects over 300 million people worldwide.
- The CYP2C19 enzyme metabolizes various antidepressants, influencing treatment outcomes.
- Genetic variations in CYP2C19 can impact drug efficacy and patient response.
Purpose of the Study:
- To systematically review the frequencies of common CYP2C19 gene variants in MDD populations.
- To evaluate the impact of these variants on MDD clinical characteristics.
- To assess the influence of CYP2C19 variants on antidepressant treatment response.
Main Methods:
- Systematic review following PRISMA protocol and PECOS strategy.
- Comprehensive literature search across five databases.
- Quality and bias risk assessment using GRIPS and STROPS guidelines.
Main Results:
- Significant variability in CYP2C19 polymorphism frequencies across different populations was observed.
- Some studies linked variants to MDD development, chronicity, and severity, while others found no association.
- Variants affected escitalopram and citalopram metabolism, but not sertraline, venlafaxine, or bupropion; treatment outcomes varied.
Conclusions:
- CYP2C19 genetic variations show population-specific frequencies and inconsistent associations with MDD.
- The impact of CYP2C19 variants on antidepressant efficacy and tolerability is drug-dependent and requires further investigation.
- Clarifying the role of these polymorphisms is crucial for optimizing MDD treatment strategies.
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