Antidepressant response and the serotonin transporter gene-linked polymorphic region

M Taylor, S Sen, Z Bhagwagar

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106 Citations (Scopus)
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Abstract

Background
The serotonin transporter gene-linked polymorphic region (5-HTTLPR) has been proposed as a predictor of antidepressant response. Insertion or deletion of a 44-base pair-long region gives rise to short “S” and long “L” forms of the promoter region, the “S” form being associated with reduced serotonin transporter expression.

Methods
A systematic review and meta-analysis was performed to clarify the effect of 5-HTTLPR on antidepressant response and remission rates. Data were obtained from 28 studies with 5408 participants. Three genotype comparisons were tested—SS versus (SL or LL), (SS or SL) versus LL, and SS versus LL.

Results
There was no statistically significant effect on antidepressant response. Compared with L carriers, there was an apparent effect of the SS genotype on remission rate (relative risk: .88; 95% confidence interval: .79–.98; p = .02). However, after trim and fill correction for missing data, the effect disappeared (relative risk: .92; 95% confidence interval: .81–1.05; p = .23), indicating that the initial significant effect was likely the result of publication bias. No significant effect on remission rate was seen for SS versus LL and SS/SL versus LL. Substantial unexplained heterogeneity of effect sizes was observed between studies, pointing to additional interacting factors contributing to an association in some cases.

Conclusions
The 5-HTTLPR biallelic short/long polymorphism by itself does not seem to usefully predict antidepressant response.
Original languageEnglish
Pages (from-to)536 - 543
Number of pages8
JournalBiological psychiatry
Volume68
Issue number6
DOIs
Publication statusPublished - 15 Sept 2010

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