This is the first study reporting that the short form of the 5-HTTLPR is significantly associated with a poorer outcome of SSRI therapy in bulimic women undergoing a naturalistic treatment. Indeed, bulimic subjects carrying at least one copy of the S allele had a 23.33-fold reduced probability to get response. Furthermore, the homozygosity for the long form of the 5-HTTLPR seems to be associated to a higher chance of remission, since patients with LL genotype had a 10.66-fold increase in the probability to get remission. These associations do not appear to be the result of pretreatment clinical or nutritional differences among patients, since neither psychiatric comorbidity, including the past history of anorexia nervosa, nor the patients' BMI affected treatment outcome; only genotype was able to explain 38% of the variance in the patients' response to SSRIs. The simplest explanation for such an association could be that, since subjects carrying the S allele likely have a reduced expression of the transporter protein, the decreased availability of 5-HTT at brain serotonergic synapses does not allow the SSRIs to fully express their therapeutic potential.
Serotonin transporter polymorphism and potential response to SSRIs in bulimia nervosa
Tortorella, Alfonso Antonio Vincenzo;
2005
Abstract
This is the first study reporting that the short form of the 5-HTTLPR is significantly associated with a poorer outcome of SSRI therapy in bulimic women undergoing a naturalistic treatment. Indeed, bulimic subjects carrying at least one copy of the S allele had a 23.33-fold reduced probability to get response. Furthermore, the homozygosity for the long form of the 5-HTTLPR seems to be associated to a higher chance of remission, since patients with LL genotype had a 10.66-fold increase in the probability to get remission. These associations do not appear to be the result of pretreatment clinical or nutritional differences among patients, since neither psychiatric comorbidity, including the past history of anorexia nervosa, nor the patients' BMI affected treatment outcome; only genotype was able to explain 38% of the variance in the patients' response to SSRIs. The simplest explanation for such an association could be that, since subjects carrying the S allele likely have a reduced expression of the transporter protein, the decreased availability of 5-HTT at brain serotonergic synapses does not allow the SSRIs to fully express their therapeutic potential.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
