Abstract
Background
The short (S) allele of the serotonin transporter gene-linked polymorphic region (5HTTLPR)
has been associated with poorer antidepressant response in major depressive disorder
(MDD) and with antidepressant-induced mania. This study investigated a possible association
with treatment-emergent insomnia or agitation.
Methods
Thirty-six outpatients with MDD were genotyped at 5HTTLPR and treated with open-label
fluoxetine up to 60 mg/day. Treatment-emergent adverse effects were assessed at each
study visit.
Results
Of nine subjects homozygous for the “S” allele, seven (78%) developed new or worsening
insomnia, versus 6 of 27 (22%) non-“S”-homozygous subjects (Fisher’s exact p = .005). Similarly, six of nine subjects homozygous for the “S” allele (67%) developed
agitation, versus 2 of 27 (7%) of non-“S”-homozygous subjects (Fisher’s exact p = .001).
Conclusions
The “S” allele of the 5HTTLPR may identify patients at risk for developing insomnia
or agitation with fluoxetine treatment. This preliminary result requires confirmation
in larger samples.
Keywords
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Article info
Publication history
Accepted:
April 14,
2003
Received in revised form:
April 1,
2003
Received:
December 12,
2002
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
