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| Content Provider | frontiers |
|---|---|
| Author | Aldrich, Stacey L. Poweleit, Ethan A. Prows, Cynthia A. Martin, Lisa J. Strawn, Jeffrey R. Ramsey, Laura B. |
| Abstract | In pediatric patients, the selective serotonin reuptake inhibitors (SSRIs) escitalopram and citalopram (es/citalopram) are commonly prescribed for anxiety and depressive disorders. However, pharmacogenetic studies examining CYP2C19 metabolizer status and es/citalopram treatment outcomes have largely focused on adults. We report a retrospective study of electronic medical record data from 263 youth < 19 years of age with anxiety and/or depressive disorders prescribed escitalopram or citalopram who underwent routine clinical CYP2C19 genotyping. Slower CYP2C19 metabolizers experienced more untoward effects than faster metabolizers (p = 0.015), including activation symptoms (p = 0.029) and had more rapid weight gain (p = 0.018). A larger proportion of slower metabolizers discontinued treatment with es/citalopram than normal metabolizers (p = 0.007). Meanwhile, faster metabolizers responded more quickly to es/citalopram (p = 0.005) and trended toward less time spent in subsequent hospitalizations (p = 0.06). These results highlight a disparity in treatment outcomes with es/citalopram treatment in youth with anxiety and/or depressive disorders when standardized dosing strategies were used without consideration of CYP2C19 metabolizer status. Larger, prospective trials are warranted to assess whether tailored dosing of es/citalopram based on CYP2C19 metabolizer status improves treatment outcomes in this patient population. |
| ISSN | 16639812 |
| DOI | 10.3389/fphar.2019.00099 |
| Volume Number | 10 |
| Journal | Frontiers in Pharmacology |
| Language | English |
| Publisher Date | 2019-02-19 |
| Access Restriction | Open |
| Subject Keyword | Depressive Disorder Pharmacogenetics Citalopram CYP2C19 Anxiety Disorders Antidepressant SSRI (selective serotonin reuptake inhibitor) Escitalopram |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology Pharmacology (medical) |
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