SYMPOSIA

Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Poster Presentations
Present data support CYP2C9 and CYP2C19 genotyping prior to phenytoin treatment in order to prevent adverse events. Consistently, for
patients carrying CYP2C9 and CYP2C19 defective alleles, valproate instead of phenytoin should be recommended to treat SE.
Grant: The study has been partly supported by the Institute of Health Carlos III-FIS and the European Union (FEDER) Grants, PI10/02010
and CP06/00030 (P Dorado) and from PRIS Extremadura, Consejería de Sanidad y Dependencia, FundeSalud PRIS10043. This study was
coordinated in the networks CIBERSAM and CAIBER, which are initiatives of ISCIII (Spain).
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S186-7
[PP-106] Ref. No: 314
Influence of CYP2D6 genetic polymorphism on fluoxetine and amitriptyline
clinical response
M. López 1 , E. Peñas Lledó 2 , H. Trejo 1 , P. Dorado 2 , J. Guerrero 2 , M. E. Alonso 3 , A. Llerena 2
1Metropolitan Autonomous University-Campus Xochimilco, Mexico City, Mexico.
2Clinical Research Centre (CICAB), Extremadura University Hospital and Medical School, Badajoz, Spain
3National Institute of Neurology and Neurosurgery Manuel Velasco Suárez. Mexico City, Mexico
E-mail: allerena@unex.es
Cytochrome P450 2D6 (CYP2D6) is involved in the metabolism of many antidepressants. It is characterized by a high individual variability
in catalytic activity mainly due to >75 CYP2D6 alleles that determine metabolizer status. The role of CYP2D6 genetic polymorphism in
the metabolism of amitriptyline and fluoxetine was previously demonstrated [LLerena et al, 2004]. Herein, we analyzed the relevance
of CYP2D6 genetic polymorphism for the clinical response to the antidepressant drugs fluoxetine and amitriptyline. Sixty-five patients
(DSM-IV) diagnosed with major depression and a score equal or greater than 17 on the Hamilton-Depression (HAM-D) were prospectively
studied. They were treated either with fluoxetine or amitriptyline under antidepressant monotherapy. The informed written consent was
obtained from all patients. Clinical Response was evaluated with HAM-D. The patients were evaluated every month. A two months period
evaluation is reported here. The patients with a 50% decrease on HAM-D were considered as “responders.” CYP2D6 genotyping was
assayed by PCR-RFLP and RT-PCR. The first month evaluation showed that 49 out of the initial 65 remained (16 dropped-out) in the study
and second month evaluation showed that 41 patients remained (8 more dropped-out). Among responders there were 56.6% and 60% to
fluoxetine, and 50% and 70% to amitriptyline, at first and second follow up evaluations, respectively. The responders were characterized
by presenting one or two CYP2D6 active genes. Furthermore, the number of active genes was related to better clinical response in both
drugs. The percentage of responders was higher for those with two active genes than for patients carrying just one: (a) fluoxetine, 81 %
vs.18 % at first month; 87% vs. 13% at second month; (b) amitriptyline, 60 % vs.40 % at first month; 83% vs. 17% at second month. All
ultrarapid metabolizers (n=3 UMs; those with more than two CYP2D6 active genes) were found to drop out during the first month. The
only poor metabolizer patient in the study (PM; with none CYP2D6 active genes) was found among “non-responders” in both follow-up
evaluations. The number of CYP2D6 active genes seems to be related to clinical response to the antidepressant drugs amitriptyline or
fluoxetine. Among responders, the frequency of patients carrying two CYP2D6 active genes is higher than those with one copy. Moreover,
UMs and PMs were not found in this group.
Grants: Supported by grants from the Spanish Ministry of Health Instituto de Salud Carlos III and EU-FEDER PI10/02758, CP06/00030 (PD);
AEXCID (9IA006) Junta de Extremadura and EU-FEDER (BS10023) and Consejo Nacional de Ciencia y Tecnología de México (Nº 59366). This
work was coordinated by Network Red Iberoamericana de Farmacogenética y Farmacogenómica (CYTED206RT0290).
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S187
[PP-107] Ref. No: 137
Evaluation of insight and functional recovery in patients with schizophrenia
Aykut Karahan, Ahmet Tiryaki, Baykal İskender, Evrim Özkorumak
Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Psikiyatri Ana Bilim Dalı, Trabzon, Turkey
E-mail: baykal.iskender@gmail.com
Objective: Despite the fact that functional remission is the most important goal for the treatment of schizophrenia, standard definitions
have not yet been made due to differences in measurement methods, the variability in the course of the disease, cognitive levels of the
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