Genotyping may help predict SSRI efficacy

GENOTYPING patients to predict antidepressant effectiveness may be useful in some people, according to new Australian guidelines.

The advice, from a consensus statement for the safety monitoring guidelines of treatments for major depressive disorders, was developed by Australian experts and published last week.

In selected patients with a history of medication sensitivity or resistance, there may be a limited place for CYP450 genotyping to predict poor or ultra-rapid metabolisers, it said.

However, the document stopped short of recommending routine genetic testing of patients starting antidepressants, as evidence to guide advice was lacking.

It recommended monitoring for the potential of antidepressants to interact with other drugs via inhibition of cytochrome-P450 enzymes, singling out fluvoxamine, whose inhibitory effects could persist for up to five weeks after discontinuation.

The statement, developed by the Australasian