Pharmacogenomic Study to Predict Antidepressant Responsiveness in Depressed Patients

The purpose of this study is to determine whether pharmacogenomic study predict antidepressant responsiveness in advance before the appearance of the drug effects until 4~6 weeks after drug administration.

The purpose of this study is

1. to determine whether genomic effects on antidepressant response differed by class of drug,
2. whether genomic differences between drug responders and nonresponders predict the response of antidepressant and
3. to construct the prediction model for antidepressant treatment in order to aid to select the their genetically matching drugs.

• Depression
• Adverse Reaction to Drug

• Drug: SSRI class antidepressant
  Antidepressant administration of SSRI class for 6 weeks under therapeutic dose
  Other Names:

  • fluoxetine_Prozac
  • paroxetine_Paxil, Seroxat
  • sertraline_Zoloft
• Drug: non-SSRI class antidepressant
  Antidepressant administration of non-SSRI class for 6 weeks under therapeutic dose
  Other Names:

  • milnacipran
  • venlafaxine_Effexor
  • nortriptyline_Aventyl, Pamelor, Noritren
  • mirtazapine_Avanza, Zispin, Remeron

• Experimental: SSRI treated group
  SSRI treated with fluoxetine, paroxetine, or sertraline
  Intervention: Drug: SSRI class antidepressant
• Active Comparator: non-SSRI treated group
  non-SSRI treated with milnacipran, venlafaxine, nortriptyline, or mirtazapine
  Intervention: Drug: non-SSRI class antidepressant

Inclusion Criteria:

1. Eligible patients were enrolled in the clinical trials program of hte Samsung Medical Center Geropsychiatry and Affective Disorder Clinics(Seoul, Korea). They received a semistructured diagnostic interview, the Samsung Psychiatric Evaluation Schedule. The affective disorder section of the Samsung Psychiatric Evaluation Schedule uses the Korean version of the structured clinical interview for the diagnostic and statistical manual of mental disorders, Fourth edition.
2. interview with one more patient's family member for objective diagnosis and final diagnosis decision by agreements of two more psychiatric physicians

Exclusion Criteria:

1. received psychotropic medication within 2 weeks of the study or fluoxetine within 4 weeks
2. potential study participants for pregnancy, significant medical conditions, abnormal laboratory baseline values, unstable psychiatric features(eg.suicidal), history of alcohol of drug dependence, seizures, head trauma with loss of consciousness, neurological illness, or concomitant Axis I psychiatric disorder.