The development of custom-made therapy of depression used genomic analysis concerned with the response of drug therapy

选择性5-羟色胺再摄取抑制剂（SSRI）已成为治疗抑郁症的首选药物，但仍有许多人需要选择另一种药物，如三环类抗抑郁药（TCA）。本文通过对58例患者服用氟伏沙明（fluvoxamine，FLV）12周的临床研究，分析了FLV的临床疗效与抑郁症的特征、FLV的药代动力学特征的相关性。FLV的血浆水平）、FLV的药效学特征（参见本研究结果表明，在有“足够的血药浓度”的情况下，用血浆浓度预测FLV的准确性要高于用剂量预测FLV的准确性。另外，我们发现，在确定的FLV“足够血药浓度”剂量方面存在很大的个体差异，吸烟诱导的CYP 2D 6多态性和CYP 1A 2活性可能有助于预测这种个体差异，而5-HTTLPR与FLV的抗抑郁作用之间没有显著的相关性。

Selective Serotonin-reuptake Inhibitor (SSRI) has been the first choice drug for the treatment of depression, but there are many people that should be select another drug, for example, tricyclic antidepressant (TCA). Though there were various trials underwent in the purpose of predict to antidepressant effect in the different view point, there was no established method that could be available in clinical use.We investigated 58 patients being treated with fluvoxamine (FLV) for 12 weeks, and analyzed the correlation between clinical effect of FLV and characteristics of depression, characteristics of pharmacokinetics of FLV (cf. plasma levels of FLV), characteristics of pharmacodynamics of FLV (cf. 5-HTTLPR).Result of our study, there was "enough plasma concentration" of FLV, we found that the prediction used by plasma level of FLV was more available than that used by FLV dosage. Further, we found that there are much individual differences in dosage established "enough plasma concentration" of FLV, and that CYP2D6 polymorphism and CYP1A2 activity induced by smoking might be useful for predicting this individual differences.On the other hand, there is no significantly correlation between 5-HTTLPR and antidepressant effect of FLV.It will be necessary in the future to conduct studies involving larger numbers of patients.