Escitalopram reduces attentional performance in anxious older adults with high-expression genetic variants at serotonin 2A and 1B receptors
| Autor: | Bruce G. Pollock, Peter Dore, Francis E. Lotrich, Anthony L. Hinrichs, Petra Nowotny, David Dixon, Eric J. Lenze, Meryl A. Butters |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Time Factors Generalized anxiety disorder Serotonin reuptake inhibitor Anxiety Citalopram Neuropsychological Tests Bioinformatics Polymorphism Single Nucleotide Statistics Nonparametric Article Double-Blind Method Surveys and Questionnaires mental disorders medicine Humans Escitalopram Attention Receptor Serotonin 5-HT2A Pharmacology (medical) Serotonin Uptake Inhibitors 5-HT receptor Serotonin transporter Aged Retrospective Studies Aged 80 and over Pharmacology biology Middle Aged medicine.disease Psychiatry and Mental health Receptor Serotonin 5-HT1B biology.protein Female Serotonin Psychology Selective Serotonin Reuptake Inhibitors Clinical psychology medicine.drug |
| Zdroj: | International Journal of Neuropsychopharmacology. 16:279-288 |
| ISSN: | 1469-5111 1461-1457 |
| Popis: | Older adults are among the most vulnerable to adverse cognitive effects of psychotropic medications and, therefore, the personalization of psychotropic treatment based on adverse drug reactions in this demographic is of great importance. We examined changes on neuropsychological tests of attention attributable to selective serotonin reuptake inhibitor (SSRI) treatment in anxious older adults. We also examined whether variation in serotonin receptor genes was associated with reduced attentional performance with SSRIs. We examined change from pre- to post-treatment in two attention measures – digit span and coding – in 133 adults aged ⩾60 yr with generalized anxiety disorder in a 12-wk trial of escitalopram vs. placebo. We also examined attentional change in relation to genetic variability in four central serotonin receptors: the serotonin transporter and serotonin 1A, 2A and 1B receptors. Digit span scores were significantly lowered in patients receiving escitalopram relative to placebo, indicating reduced attentional performance attributable to the SSRI. Individuals with high-transcription variants in the receptors 5-HTR2A rs6311 and 5-HTR1B rs11568817 had greater reductions in attention with SSRI treatment compared to placebo. We conclude that SSRIs reduce attention in older adults, particularly in those with high-expression genetic variants at the serotonin 2A and 1B receptors. Analysing neuropsychological changes with SSRIs in relation to genetic variation in the serotonin system may be a useful strategy for detecting subgroups of older adults who are more susceptible to side-effects of SSRIs. These results, if confirmed, could lead to the personalization of SSRI use to reduce adverse neurocognitive effects. |
| Databáze: | OpenAIRE |
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