Polymorphisms analysis of the metabolic genes in 74 patients with treatment-resistant depression

Objective To analyze the polymorphism of antidepressant-associated metabolic phenotypes in patients with treatment-resistant depression (TRD), so as to provide reference for clinical treatment. Methods TRD patients who were admitted in Xuzhou Oriental People's Hospital from September 2018 to May 2020 were enrolled and their diagnosis and treatment information and pharmacogenomics test results were examined. The following gene polymorphism was analyzed, including CYP1A2(^*1,^*1C,^*1F,^*6), CYP2C19(^*1,^*10,^*17,^*2,^*3,^*35,^*4), CYP2C9(^*1,^*2,^*3), CYP2D6(^*1,^*10,^*14A,^*14B,^*2,^*2A,^*4,^*41) and CYP3A4(^*1,^*20,^*26). Results 91.89% of TRD patients presented more than one mutant metabolic phenotypes, especially in CYP2C19 (59.46%) and CYP2D6 (64.86%), with the most frequent frequency of poor metabolizers. No mutation was found in 8.11% of TRD patients. Conclusions TRD patients have a high mutant rate of metabolic phenotype, expecially in CYP2C19 and CYP2D6, with the most frequent frequency of poor metabolizers. But we must be alert to the possibility of false treatment-resistance.