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Genetic markers anticipate response to citalopram in a majority of patients

Alemi, Farrokha; Zargoush, Manaff; Erdman, Harolda; Vang, Jeea; Epstein, Steveb; Ayman, Fanousb,c,d,e

doi: 10.1097/YPG.0b013e3283480485
Original Articles

Objective Scientists have concluded that genetic profiles cannot predict a large percentage of variation in response to citalopram, a common antidepressant. Using the same data, we examined if a different conclusion can be arrived at when the results are personalized to fit specific patients.

Methods We used data available through the Sequenced Treatment Alternatives to Relieve Depression database. We created three boosted Classification and Regression Trees to identify 16 subgroups of patients, among whom anticipation of positive or negative response to citalopram was significantly different from 0.5 (P≤0.1).

Results In a 10-fold cross-validation, this ensemble of trees made no predictions in 33% of cases. In the remaining 67% of cases, it accurately classified response to citalopram in 78% of cases.

Conclusion For the majority of the patients, genetic markers can be used to guide selection of citalopram. The rules identified in this study can help personalize prescription of antidepressants.

aDepartment of Health Systems Administration

bDepartment of Psychiatry, Georgetown University

cMental Health Service Line, Washington VA Medical Center, Northwest, Washington, District of Columbia

dDepartment of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia

eDepartment of Psychiatry, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA

fESSEC Business School, Avenue Bernard Hirsch, Cergy-Pontoise Cedex, France

Correspondence to Farrokh Alemi, PhD, Department of Health Systems Administration, Georgetown University, 3700 Reservoir Road, Washington, DC 20007, USA Tel: +1 703 283 3100; fax: +1 202 784 3127; e-mail: alemi@cox.net

Received September 22, 2010

Accepted March 6, 2011

© 2011 Lippincott Williams & Wilkins, Inc.