QUALIDADE DE VIDA, SINTOMAS DE DEPRESSÃO E ADESÃO AO TRATAMENTO EM PACIENTES COM TRANSTORNO DEPRESSIVO MAIOR

Abstract

Introduction: Patients with major depression usually respond to treatment with antidepressant drugs, however in 10% to 30% of cases there is only a partial response or no response, among the factors that can influence is the profile of liver enzymes metabolizing antidepressants , such as CYP2C19. Objective: To investigate CYP2C19*2 or CYP2C19*17 polymorphisms in patients with major depressive disorder (MDD) treated with citalopram or escitalopram, and to verify associations with treatment adherence, symptoms of depression and quality of life. Methodology: This is a case series study carried out with 29 patients with MDD. Blood samples were collected for CYP2C19 genotyping by TaqMan® allelic discrimination. Data on demographic and socioeconomic profile, treatment adherence (Morisky scale), symptoms of depression (Hamilton scale) and quality of life (WHOQoL-BREF) were collected. Results: There were four patients with (13.8%) CYP219*2 and 10 (34.4%) CYP219*17 polymorphisms. There was higher prevalence of CYP219*17 compared to CYP2C19*2 (p>0.05). In general, no association between socioeconomic, demographic, and clinical features with CYP2C19 genotypes was observed. Moderate adherence to treatment was predominant for CYP2C19*2 and CYP219*17 patients (p>0.05).  No statistically significant association was observed between symptoms of depression and genetic polymorphisms (p>0.05). A significant association between polymorphic CC genotype of CYP219*17 with health satisfaction, while the CT genotype was associated with “neither satisfied/nor dissatisfied” status (p<0.05). Most of the CYP2C19*2 and CYP2C19*17 subjects reported “need to improve” or “regular” regarding physical, psychological, social, and environmental domains (p>0.05). Conclusions: The cases showed a higher prevalence of CYP219*17 polymorphism, with moderate treatment adherence. Many subjects, even under the effect of the medication, presented intense to moderate symptoms of depression, and reported impairment in health satisfaction.