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<p><b>Objective.</b> To evaluate the associations of carriership of the <i>CYP2C19*2</i> and <i>*17</i> polymorphic variants with measures of the efficacy and safety of sertraline in adolescents with depressive episode and suicidal tendencies over eight weeks. <b>Materials and methods.</b> The study included 91 adolescents aged 12–17 years, hospitalized with a clinical picture of depressive episode and suicidal tendencies. Inclusion was restricted to patients prescribed sertraline. Evaluation of the efficacy and safety of pharmacotherapy using psychometric scales took place on days 7 and 21 (in hospital) and in week 8 (outpatient period) of sertraline administration. The Clinical Global Impression scales (CGI-S and CGI-I), the Child Global Assessment of Mental State and Adjustment Scale (CGAS), the Columbia Suicide Rating Scale (C-SSRS), the Beck Depression Inventory, and the Antidepressant Adverse Reaction Questionnaire were used. All patients underwent pharmacogenetic testing for <i>CYP2C19*2</i>, <i>*3</i>, and <i>*17</i>. <b>Results.</b> The mean age of patients was 15 [14; 16] years, 87.9% were girls. No differences were found in the CGAS, CGI-S, CGI-I, C-SSRS, or Beck Depression Inventory scores over the entire observation period between carriers of <i>CYP2C19*2</i>, <i>CYP2C19*17</i>, or the wild-type genotype. <i>CYP2C19*17</i> carriers reported more adverse mental reactions at treatment week 8 (1 [0; 2] vs. 0 [0; 1]; <i>p</i> = 0.028). After eight weeks, weakness was more common in <i>CYP2C19*17</i> carriers (<i>p</i> = 0.013) and normal and ultrafast CYP2C19 metabolizers (<i>p</i> = 0.046). <b>Conclusions.</b> Carriers of the <i>CYP2C19*17</i> polymorphic variant complained of adverse reactions more often than carriers of the wild genotypes. This result is paradoxical when compared with previously conducted studies among adult patients.</p>

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Associations the Polymorphic Variants CYP2C19*2 and *17 with the Effectiveness and Safety of Sertraline in Adolescents with Depressive Episode and Suicidal Tendencies

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • D. V. Ivashchenko,
  • S. V. Grass,
  • V. V. Sobur,
  • P. V. Shimanov,
  • A. V. Shubin,
  • R. V. Deich,
  • R. V. Kondratieva,
  • E. N. Shagovenko,
  • Yu. V. Chernetsova,
  • S. N. Tuchkova,
  • N. P. Denisenko,
  • K. B. Mirzaev,
  • A. Ya. Basova,
  • Yu. S. Shevchenko,
  • D. A. Sychev

摘要

Objective. To evaluate the associations of carriership of the CYP2C19*2 and *17 polymorphic variants with measures of the efficacy and safety of sertraline in adolescents with depressive episode and suicidal tendencies over eight weeks. Materials and methods. The study included 91 adolescents aged 12–17 years, hospitalized with a clinical picture of depressive episode and suicidal tendencies. Inclusion was restricted to patients prescribed sertraline. Evaluation of the efficacy and safety of pharmacotherapy using psychometric scales took place on days 7 and 21 (in hospital) and in week 8 (outpatient period) of sertraline administration. The Clinical Global Impression scales (CGI-S and CGI-I), the Child Global Assessment of Mental State and Adjustment Scale (CGAS), the Columbia Suicide Rating Scale (C-SSRS), the Beck Depression Inventory, and the Antidepressant Adverse Reaction Questionnaire were used. All patients underwent pharmacogenetic testing for CYP2C19*2, *3, and *17. Results. The mean age of patients was 15 [14; 16] years, 87.9% were girls. No differences were found in the CGAS, CGI-S, CGI-I, C-SSRS, or Beck Depression Inventory scores over the entire observation period between carriers of CYP2C19*2, CYP2C19*17, or the wild-type genotype. CYP2C19*17 carriers reported more adverse mental reactions at treatment week 8 (1 [0; 2] vs. 0 [0; 1]; p = 0.028). After eight weeks, weakness was more common in CYP2C19*17 carriers (p = 0.013) and normal and ultrafast CYP2C19 metabolizers (p = 0.046). Conclusions. Carriers of the CYP2C19*17 polymorphic variant complained of adverse reactions more often than carriers of the wild genotypes. This result is paradoxical when compared with previously conducted studies among adult patients.