Brain-derived neurotrophic factor Va166Met polymorphism and 6-month antidepressant remission in depressed Caucasian patients

Background: Whether the Brain Derived Neurotrophic Factor (BENNE.) Va166Met polymorphism can predict antidepressant drug efficacy in depressed patients remains unclear, suggesting that it may depend on antidepressant classes. We assessed the impact of Va166Met polymorphism on antidepressant response and remission depending on antidepressant classes. Methods: In a 6-month prospective, real-world setting, treatment study, 345 Caucasian depressed patients requiring a new or different drug treatment with a selective serotonin reuptake inhibitor (SSRI), a serotonin and noradrenalin reuptake inhibitor (SNRI) or a tricyclic antidepressant (TCA), were genotyped and assessed for response and remission. Results: 231 (67%) patients were homozygous for the Va166 allele (Val/Val) and 114 (33%) were carriers of Met allele (Met). 152 (44.1%) patients were treated with SSRI, the others with SNRI/TCA. Both response and remission were explained by interactions between the Va166Met polymorphism and antidepressant dnig classes (multivariate models adjusted for propensity-scores: p=0.02 ancl p=0.03 respectively) With SSRL Val/ Val patients had a higher response rate 3 months post-treatment than Met patients (68.1% versus 44%; adjusted-OR: 3.04, IC95% [1.05; 9.37], p=0.04). With SNRUTCA, Val/Val patients had a lower remission rate 6 months post-treatment than Met patients (333% versus 60.9%, adjusted-OR: 0.27,IC95% 10.09; 0.761, p=0.02). Limitations: Limited sample size. Conclusions: This study argues for a personalized prescription of antidepressants in Caucasian patients with major depressive disorder, based on the BDNF Va166Met polymorphism: SSRI should be preferred for Val/Val patients and SNRI/TCA for Met patients. Further studies are required to confirm these data. (C) 2015 Elsevier B.V. All rights reserved.