Serotonin Transporter Gene Promotor Polymorphism (5-HTTLPR) Associations with Number of Psychotropic Medication Trials in a Tertiary Care Outpatient Psychiatric Consultation Practice

James R. Rundell, Jeffrey P Staab, Gen Shinozaki, Donald McAlpine

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: The authors tested the hypothesis that the short allele of 5-HTTLPR is associated with number of psychotropic medication trials as a measure of treatment-resistance or intolerance in psychosomatic medicine (PM) outpatients. Methods: Review of Mayo Clinic PM outpatient 2008 records identified 44 (20.6%) who had 5-HTTLPR genotype tests. A univariate analysis screened for factors that could account for number of medication trials. Logistic regression then determined degree of association between 5-HTTLPR genotype category and number of pharmacological trials. Results: Univariate analysis revealed significant differences across the ordinal genotype spectrum long/long, short/long, short/short in mean number of overall psychotropic medication trials (8.9, 14.8, 18.0, P = 0.002), mean number of antidepressant trials (4.3, 7.2, 8.1, P = 0.018), mean number of mood stabilizer trials (0.8, 1.9, 2.3, P = 0.008), percent living alone (7%, 25%, 50%, P = 0.020), reported family history of depression (93%, 65%, 40%, P = 0.006), and reported family history of chemical dependency treatment (50%, 35%, 10%, P = 0.050). There were trends for differences in consultation reason for unexplained symptoms (14%, 25%, 50%, P = 0.063), and diagnoses of somatoform disorder (7%, 30%, 40%, P = 0.060), and generalized anxiety disorder (43%, 65%, 80%, P = 0.064). After controlling for other differences, presence of the short allele remained associated with number of psychotropic medication trials (OR 4.779, 95% CI 2.263-6.771, P = 0.004), and number of antidepressant trials (OR 1.591, 95% CI 1.072-2.762, P = 0.019). Conclusion: 5-HTTLPR testing may identify PM outpatients at higher relative risk for pharmacotherapy treatment non-response or intolerance who may benefit from alternative or augmentative medication recommendations or non-pharmacological interventions.

Original languageEnglish (US)
Pages (from-to)147-153
Number of pages7
JournalPsychosomatics
Volume52
Issue number2
DOIs
StatePublished - Mar 2011

Fingerprint

Psychosomatic Medicine
Serotonin Plasma Membrane Transport Proteins
Tertiary Healthcare
Psychiatry
Outpatients
Referral and Consultation
Genotype
Antidepressive Agents
Alleles
Genes
Somatoform Disorders
Anxiety Disorders
Statistical Factor Analysis
Therapeutics
Logistic Models
Pharmacology
Depression
Drug Therapy
Medication
Polymorphism

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)

Cite this

Serotonin Transporter Gene Promotor Polymorphism (5-HTTLPR) Associations with Number of Psychotropic Medication Trials in a Tertiary Care Outpatient Psychiatric Consultation Practice. / Rundell, James R.; Staab, Jeffrey P; Shinozaki, Gen; McAlpine, Donald.

In: Psychosomatics, Vol. 52, No. 2, 03.2011, p. 147-153.

Research output: Contribution to journalArticle

@article{5542e53f47eb4053b70280ca3dec00a7,
title = "Serotonin Transporter Gene Promotor Polymorphism (5-HTTLPR) Associations with Number of Psychotropic Medication Trials in a Tertiary Care Outpatient Psychiatric Consultation Practice",
abstract = "Objective: The authors tested the hypothesis that the short allele of 5-HTTLPR is associated with number of psychotropic medication trials as a measure of treatment-resistance or intolerance in psychosomatic medicine (PM) outpatients. Methods: Review of Mayo Clinic PM outpatient 2008 records identified 44 (20.6{\%}) who had 5-HTTLPR genotype tests. A univariate analysis screened for factors that could account for number of medication trials. Logistic regression then determined degree of association between 5-HTTLPR genotype category and number of pharmacological trials. Results: Univariate analysis revealed significant differences across the ordinal genotype spectrum long/long, short/long, short/short in mean number of overall psychotropic medication trials (8.9, 14.8, 18.0, P = 0.002), mean number of antidepressant trials (4.3, 7.2, 8.1, P = 0.018), mean number of mood stabilizer trials (0.8, 1.9, 2.3, P = 0.008), percent living alone (7{\%}, 25{\%}, 50{\%}, P = 0.020), reported family history of depression (93{\%}, 65{\%}, 40{\%}, P = 0.006), and reported family history of chemical dependency treatment (50{\%}, 35{\%}, 10{\%}, P = 0.050). There were trends for differences in consultation reason for unexplained symptoms (14{\%}, 25{\%}, 50{\%}, P = 0.063), and diagnoses of somatoform disorder (7{\%}, 30{\%}, 40{\%}, P = 0.060), and generalized anxiety disorder (43{\%}, 65{\%}, 80{\%}, P = 0.064). After controlling for other differences, presence of the short allele remained associated with number of psychotropic medication trials (OR 4.779, 95{\%} CI 2.263-6.771, P = 0.004), and number of antidepressant trials (OR 1.591, 95{\%} CI 1.072-2.762, P = 0.019). Conclusion: 5-HTTLPR testing may identify PM outpatients at higher relative risk for pharmacotherapy treatment non-response or intolerance who may benefit from alternative or augmentative medication recommendations or non-pharmacological interventions.",
author = "Rundell, {James R.} and Staab, {Jeffrey P} and Gen Shinozaki and Donald McAlpine",
year = "2011",
month = "3",
doi = "10.1016/j.psym.2010.12.013",
language = "English (US)",
volume = "52",
pages = "147--153",
journal = "Psychosomatics",
issn = "0033-3182",
publisher = "American Psychiatric Publishing Inc.",
number = "2",

}

TY - JOUR

T1 - Serotonin Transporter Gene Promotor Polymorphism (5-HTTLPR) Associations with Number of Psychotropic Medication Trials in a Tertiary Care Outpatient Psychiatric Consultation Practice

AU - Rundell, James R.

AU - Staab, Jeffrey P

AU - Shinozaki, Gen

AU - McAlpine, Donald

PY - 2011/3

Y1 - 2011/3

N2 - Objective: The authors tested the hypothesis that the short allele of 5-HTTLPR is associated with number of psychotropic medication trials as a measure of treatment-resistance or intolerance in psychosomatic medicine (PM) outpatients. Methods: Review of Mayo Clinic PM outpatient 2008 records identified 44 (20.6%) who had 5-HTTLPR genotype tests. A univariate analysis screened for factors that could account for number of medication trials. Logistic regression then determined degree of association between 5-HTTLPR genotype category and number of pharmacological trials. Results: Univariate analysis revealed significant differences across the ordinal genotype spectrum long/long, short/long, short/short in mean number of overall psychotropic medication trials (8.9, 14.8, 18.0, P = 0.002), mean number of antidepressant trials (4.3, 7.2, 8.1, P = 0.018), mean number of mood stabilizer trials (0.8, 1.9, 2.3, P = 0.008), percent living alone (7%, 25%, 50%, P = 0.020), reported family history of depression (93%, 65%, 40%, P = 0.006), and reported family history of chemical dependency treatment (50%, 35%, 10%, P = 0.050). There were trends for differences in consultation reason for unexplained symptoms (14%, 25%, 50%, P = 0.063), and diagnoses of somatoform disorder (7%, 30%, 40%, P = 0.060), and generalized anxiety disorder (43%, 65%, 80%, P = 0.064). After controlling for other differences, presence of the short allele remained associated with number of psychotropic medication trials (OR 4.779, 95% CI 2.263-6.771, P = 0.004), and number of antidepressant trials (OR 1.591, 95% CI 1.072-2.762, P = 0.019). Conclusion: 5-HTTLPR testing may identify PM outpatients at higher relative risk for pharmacotherapy treatment non-response or intolerance who may benefit from alternative or augmentative medication recommendations or non-pharmacological interventions.

AB - Objective: The authors tested the hypothesis that the short allele of 5-HTTLPR is associated with number of psychotropic medication trials as a measure of treatment-resistance or intolerance in psychosomatic medicine (PM) outpatients. Methods: Review of Mayo Clinic PM outpatient 2008 records identified 44 (20.6%) who had 5-HTTLPR genotype tests. A univariate analysis screened for factors that could account for number of medication trials. Logistic regression then determined degree of association between 5-HTTLPR genotype category and number of pharmacological trials. Results: Univariate analysis revealed significant differences across the ordinal genotype spectrum long/long, short/long, short/short in mean number of overall psychotropic medication trials (8.9, 14.8, 18.0, P = 0.002), mean number of antidepressant trials (4.3, 7.2, 8.1, P = 0.018), mean number of mood stabilizer trials (0.8, 1.9, 2.3, P = 0.008), percent living alone (7%, 25%, 50%, P = 0.020), reported family history of depression (93%, 65%, 40%, P = 0.006), and reported family history of chemical dependency treatment (50%, 35%, 10%, P = 0.050). There were trends for differences in consultation reason for unexplained symptoms (14%, 25%, 50%, P = 0.063), and diagnoses of somatoform disorder (7%, 30%, 40%, P = 0.060), and generalized anxiety disorder (43%, 65%, 80%, P = 0.064). After controlling for other differences, presence of the short allele remained associated with number of psychotropic medication trials (OR 4.779, 95% CI 2.263-6.771, P = 0.004), and number of antidepressant trials (OR 1.591, 95% CI 1.072-2.762, P = 0.019). Conclusion: 5-HTTLPR testing may identify PM outpatients at higher relative risk for pharmacotherapy treatment non-response or intolerance who may benefit from alternative or augmentative medication recommendations or non-pharmacological interventions.

UR - http://www.scopus.com/inward/record.url?scp=79958177106&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958177106&partnerID=8YFLogxK

U2 - 10.1016/j.psym.2010.12.013

DO - 10.1016/j.psym.2010.12.013

M3 - Article

C2 - 21397107

AN - SCOPUS:79958177106

VL - 52

SP - 147

EP - 153

JO - Psychosomatics

JF - Psychosomatics

SN - 0033-3182

IS - 2

ER -