DOI: https://doi.org/10.14710/jbtr.v10i1.20338

The Influence of CYP2C19 Gene Polymorphism on Selective Serotonin Reuptake Inhibitors In Patients with Major Depressive Disorder: A Pharmacogenetic Prospecting Approach

1Department of Pharmacy, Faculty of Health Science, Universitas Singaperbangsa Karawang, Indonesia

2Department and Division of Practical Cosmetology and Skin Disease Prophylaxis, Poznan University of Medical Sciences, Indonesia

3Microbiology and Biotechnology Laboratory, Faculty of Pharmacy, Universitas Indonesia, Indonesia

4 Helix Laboratory and Clinic, Indonesia

5 Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Indonesia

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Received: 22 Sep 2023; Accepted: 29 Apr 2024; Available online: 30 Apr 2024; Published: 30 Apr 2024.
Open Access Copyright (c) 2024 Journal of Biomedicine and Translational Research
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Abstract

Major Depressive Disorder (MDD) is a chronic disorder characterized by at least a two-week-long major depressive episode. Selective Serotonin Reuptake Inhibitors (SSRIs) remain the primary prescribed antidepressants to treat MDD. However, SSRIs themselves are found to be ineffective in some individuals or may even lead to adverse side effects. These variable responses have been linked to the drug being metabolized by CYP2C19, which exhibited various polymorphisms. Understanding how gene polymorphism affects drug metabolism is essential since these insights can revolutionize clinical practice, allowing for more precise and personalized treatment approaches that optimize efficacy while minimizing side effects. This issue is particularly pertinent in Indonesia, where research in this area lags behind the pressing need for such studies. In this review, the impact of CYP2C19 polymorphism on the effectiveness of SSRI class drugs, namely citalopram, escitalopram, and sertraline, are explored. Nine relevant articles related to the topic have been studied in Japan, China, Turkey, Russia, Scandinavia, and Australia. The results concluded that CYP2C19 polymorphism can influence the metabolism of SSRIs (citalopram, escitalopram, and sertraline) due to its variability in enzyme activities, which includes both loss-of-function (*2, *3) and gain-of-function (*17) polymorphisms. Consequently, these genetic variations can lead to significant changes in drug efficacy and safety changes within individual patients. This review sheds light on the importance of considering genetic factors when prescribing SSRIs for MDD in the future treatment strategies.

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Keywords: Major Depressive Disorder; CYP2C19; Gene Polymorphism; Selective Serotonin Reuptake Inhibitors; Drug Metabolism

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Section: Review Articles
Language : EN
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