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Pharmacogenetic implications for antidepressant pharmacotherapy in late-life depression: A systematic review of the literature for response, pharmacokinetics and adverse drug reactions

The American Journal of Geriatric Psychiatry Feb 07, 2020

Marshe VS, Islam F, Maciukiewicz M, et al. - Given the challenges encountered in treating late-life depression that affects up to 15% of older adults and the possible value of predictive genetic testing for improving treatment in this vulnerable population, researchers here sought to summarize the literature investigating genetic associations with antidepressant treatment outcomes in late-life. Via systematically searching three integrated electronic databases, 29 articles were identified that examined genetic associations with antidepressant treatment outcomes, pharmacokinetic parameters, and adverse drug reactions in older adults. They identified only a small number of works conducted in older adults making it difficult to conclude the presence or absence of genetic associations with the outcomes of interest. In total, there was a most substantial amount of evidence for the CYP2D6 metabolizer status, SLC6A4 5-HTTLPR, and BDNF rs6265. When not limiting to older adults, these findings remain consistent in the literature, inferring that similar treatment recommendations may be implemented for older adults concerning genetic variation, such as those outlined for CYP2D6 by the Clinical Pharmacogenetics Implementation Consortium.
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