Testing for cytochrome P450 polymorphisms in adults with non-psychotic depression treated with selective serotonin reuptake inhibitors (SSRIs).
Matchar DB, Thakur ME, Grossman I, McCrory DC, Orlando LA, Steffens DC, Goldstein DB, Cline KE, Gray RN
Record ID 32007000024
English
Authors' objectives:
The aim of this report is to determine if testing for cytochrome P450 (CYP450) polymorphisms in adults entering selective serotonin reuptake inhibitor (SSRI) treatment for non-psychotic depression leads to improvement in outcomes, or if testing results are useful in medical, personal, or public health decisionmaking.
Authors' results and conclusions:
A review of 1,200 abstracts led to the final inclusion of 37 articles. The evidence indicates the existence of tests with high sensitivity and specificity for detecting only a few of the more common known polymorphisms of 2D6, 2C19, 2C8, 2C9, and 1A1. There is mixed evidence regarding the association between CYP450 genotypes and SSRI metabolism, efficacy, and tolerability in the treatment of depression, mainly from a series of heterogeneous studies in small samples. There are no data regarding:
(a) if testing for CYP450 polymorphisms in adults entering SSRI treatment for non-psychotic depression leads to improvement in outcomes versus not testing, or if testing results are useful in medical, personal, or public health decisionmaking.
(b) if CYP450 testing influences depression management decisions by patients and providers in ways that could improve or worsen outcomes.
(c) if there are direct or indirect harms associated with testing for CYP450 polymorphisms or with subsequent management options.
Authors' recommendations:
There is a paucity of good-quality data addressing the questions of whether testing for CYP450 polymorphisms in adults entering SSRI treatment for non-psychotic depression leads to improvement in outcomes, or whether testing results are useful in medical, personal, or public health decisionmaking.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.ahrq.gov/downloads/pub/evidence/pdf/cyp450/cyp450.pdf
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Cytochrome P-450 Enzyme System
- Depression
- Selective Serotonin Reuptake Inhibitors
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.