ArticleTranslational psychiatry2022
Effects of CYP2C19 and CYP2D6 gene variants on escitalopram and aripiprazole treatment outcome and serum levels: results from the CAN-BIND 1 study.
Article in Translational psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Machine learning approaches in the therapeutic outcome prediction in major depressive disorder: a systematic review.Frontiers in psychiatry · 2025Pooled it
- Metabolic activity of CYP2C19 and CYP2D6 on antidepressant response from 13 clinical studies using genotype imputation: a meta-analysis.Translational psychiatry · 2024Pooled it
- Evidence level for pharmacogenetic testing in antidepressant treatment: a systematic review.PharmacogenomicsPooled it
- Application of escitalopram population pharmacokinetic repository: a step to precision dosing.Translational psychiatry · 2026Article
- Influence of combined CYP2C19 and CYP2D6 phenotypes on adverse drug reactions in patients with major depressive disorder: a clinical cohort study.The pharmacogenomics journal · 2026Article
- Pharmacogenetics of antidepressant response: a focused review on CYP2C19, CYP2D6, SLC6A4, and HTR2A polymorphisms.Frontiers in pharmacology · 2026Review
- Prevalence ofAnnals of neurosciences · 2025Article
- Genetic influences on antidepressant side effects: a CYP2C19 gene variation and polygenic risk study in the Estonian Biobank.European journal of human genetics : EJHG · 2025Article
- Effectiveness and safety of escitalopram treatment personalized based on therapeutic drug monitoring of drug plasma concentration: a prospective cohort study.Scientific reports · 2025Observational
- BDNF/BDNF-AS Gene Polymorphisms Modulate Treatment Response and Remission in Bipolar Disorder: A Randomized Clinical Trial.Journal of personalized medicine · 2025Article
- Serotonin transporter 5-HTTLPR polymorphism and escitalopram treatment response in patients with major depressive disorder.BMC psychiatry · 2024Article
- Influence ofCanadian journal of psychiatry. Revue canadienne de psychiatrie · 2024Article
- A New Intervention for Implementation of Pharmacogenetics in Psychiatry: A Description of the PSY-PGx Clinical Study.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Effects of Aripiprazole on Olanzapine Population Pharmacokinetics and Initial Dosage Optimization in Schizophrenia Patients.Neuropsychiatric disease and treatment · 2024Article
- Meta-analysis of CYP2C19 and CYP2D6 metabolic activity on antidepressant response from 13 clinical studies using genotype imputation.medRxiv : the preprint server for health sciences · 2023Article
- Escitalopram Personalized Dosing: A Population Pharmacokinetics Repository Method.Drug design, development and therapy · 2023Review
- Pharmacogenetic Dose Modeling Based on CYP2C19 Allelic Phenotypes.Pharmaceutics · 2022Article
- Utilizing pharmacogenetics when treating first episode psychosis.Journal of psychiatry & neuroscience : JPNArticle
Corrections and comments
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Authors and funding
21 authors at 14 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cytochrome P450 drug-metabolizing enzymes may contribute to interindividual differences in antidepressant outcomes. We investigated the effects of CYP2C19 and CYP2D6 gene variants on response, tolerability, and serum concentrations. Patients (N = 178) were treated with escitalopram (ESC) from weeks 0-8 (Phase I), and at week 8, either continued ESC if they were responders or were augmented with aripiprazole (ARI) if they were non-responders (<50% reduction in Montgomery-Åsberg Depression Rating Scale from baseline) for weeks 8-16 (Phase II). Our results showed that amongst patients on ESC-Only, CYP2C19 intermediate and poor metabolizers (IM + PMs), with reduced or null enzyme function, trended towards significantly lower symptom improvement during Phase II compared to normal metabolizers (NMs), which was not observed in ESC + ARI. We further showed that CYP2D6 NMs and IM + PMs had a higher likelihood of reporting a treatment-related central nervous system side effect in ESC-Only and ESC + ARI, respectively. The differences in the findings between ESC-Only and ESC + ARI may be due to the altered pharmacokinetics of ESC by ARI coadministration in ESC + ARI. We provided evidence for this postulation when we showed that in ESC-Only, CYP2C19 and CYP2D6 IM + PMs demonstrated significantly higher ESC concentrations at Weeks 10 and 16 compared to NMs. In contrast, ESC + ARI showed an association with CYP2C19 but not with CYP2D6 metabolizer group. Instead, ESC + ARI showed an association between CYP2D6 metabolizer group and ARI metabolite-to-drug ratio suggesting potential competition between ESC and ARI for CYP2D6. Our findings suggest that dosing based on CYP2C19 and CYP2D6 genotyping could improve safety and outcome in patients on ESC monotherapy.
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