Controlled clinical comparison of paroxetine and fluvoxamine considering the serotonin transporter promoter polymorphism

Masaki Kato; Yuka Ikenaga; Masataka Wakeno; Gaku Okugawa; Kenji Nobuhara; Tsuyoshi Fukuda; Kazuhiro Fukuda; Junichi Azuma; Toshihiko Kinoshita

doi:10.1097/00004850-200505000-00005

Controlled clinical comparison of paroxetine and fluvoxamine considering the serotonin transporter promoter polymorphism

Int Clin Psychopharmacol. 2005 May;20(3):151-6. doi: 10.1097/00004850-200505000-00005.

Authors

Masaki Kato¹, Yuka Ikenaga, Masataka Wakeno, Gaku Okugawa, Kenji Nobuhara, Tsuyoshi Fukuda, Kazuhiro Fukuda, Junichi Azuma, Toshihiko Kinoshita

Affiliation

¹ Department of Neuropsychiatry, Kansai Medical University, Moriguchi, Osaka, Japan. katom@takii.kmu.ac.jp

PMID: 15812265
DOI: 10.1097/00004850-200505000-00005

Abstract

The present study aimed to compare the effects of two currently used selective serotonin reuptake inhibitors (SSRIs) in Japan taking the individual background in 5-HTT gene-linked polymorphic region (5HTTLPR) genotype into account. Clinical responses to paroxetine and fluvoxamine were evaluated by total and cluster depressive symptoms for 81 Japanese patients who were diagnosed with major depression. Patients with the l allele had a greater percentage reduction on the total score (P=0.059) and somatic anxiety items (P=0.026) of the 21-item Hamilton Depression Rating Scale (HAM-D) score compared to s/s genotype carriers. Paroxetine was significantly more effective than fluvoxamine in the s/s carriers, as evaluated on the percentage reduction in total score (P=0.012) and core (P=0.049) HAM-D after 4 weeks of medication, but not in the l/s carriers. These findings suggest that the genetic test may be useful in investigating the efficacy of the two SSRIs, and that normalization by the 5HTTLPR genotypes may lead to improvement of the precision of comparative analysis.

Publication types

Clinical Trial
Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antidepressive Agents, Second-Generation / adverse effects
Antidepressive Agents, Second-Generation / therapeutic use*
Chromatography, High Pressure Liquid
Depressive Disorder / drug therapy*
Depressive Disorder / genetics*
Female
Fluvoxamine / adverse effects
Fluvoxamine / therapeutic use*
Genotype
Heterozygote
Humans
Male
Membrane Glycoproteins / genetics*
Membrane Transport Proteins / genetics*
Middle Aged
Nerve Tissue Proteins / genetics*
Paroxetine / adverse effects
Paroxetine / therapeutic use*
Patient Dropouts
Polymorphism, Genetic / genetics
Promoter Regions, Genetic / genetics
Psychiatric Status Rating Scales
Selective Serotonin Reuptake Inhibitors / adverse effects
Selective Serotonin Reuptake Inhibitors / therapeutic use*
Serotonin Plasma Membrane Transport Proteins

Substances

Antidepressive Agents, Second-Generation
Membrane Glycoproteins
Membrane Transport Proteins
Nerve Tissue Proteins
SLC6A4 protein, human
Serotonin Plasma Membrane Transport Proteins
Serotonin Uptake Inhibitors
Paroxetine
Fluvoxamine