Exploratory genome-wide association analysis of response to ketamine and a polygenic analysis of response to scopolamine in depression

Transl Psychiatry. 2018 Dec 14;8(1):280. doi: 10.1038/s41398-018-0311-7.

Abstract

Growing evidence suggests that the glutamatergic modulator ketamine has rapid antidepressant effects in treatment-resistant depressed subjects. The anticholinergic agent scopolamine has also shown promise as a rapid-acting antidepressant. This study applied genome-wide markers to investigate the role of genetic variants in predicting acute antidepressant response to both agents. The ketamine-treated sample included 157 unrelated European subjects with major depressive disorder (MDD) or bipolar disorder (BD). The scopolamine-treated sample comprised 37 unrelated European subjects diagnosed with either MDD or BD who had a current Major Depressive Episode (MDE), and had failed at least two adequate treatment trials for depression. Change in Montgomery-Asberg Depression Rating Scale (MADRS) or the 17-item Hamilton Depression Rating Scale (HAM-D) scale scores at day 1 (24 h post-treatment) was considered the primary outcome. Here, we conduct pilot genome-wide association study (GWAS) analyses to identify potential markers of ketamine response and dissociative side effects. Polygenic risk score analysis of SNPs ranked by the strength of their association with ketamine response was then calculated in order to assess whether common genetic markers from the ketamine study could predict response to scopolamine. Findings require replication in larger samples in light of low power of analyses of these small samples. Neverthless, these data provide a promising illustration of our future potential to identify genetic variants underlying rapid treatment response in mood disorders and may ultimately guide individual patient treatment selection in the future.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / genetics*
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / genetics*
  • Female
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study
  • Humans
  • Ketamine / therapeutic use*
  • Male
  • Middle Aged
  • Multifactorial Inheritance
  • Pharmacogenomic Testing*
  • Pilot Projects
  • Polymorphism, Single Nucleotide
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Scopolamine / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Antidepressive Agents
  • Ketamine
  • Scopolamine