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Escitalopram response

MedGen UID:
808074
•Concept ID:
CN221264
•
Sign or Symptom
Synonym: Lexapro response
Drug:
Escitalopram
MedGen UID:
203862
•Concept ID:
C1099456
•
Pharmacologic Substance
The active S-stereoisomer of the selective serotonin reuptake inhibitor (SSRI) citalopram with antidepressant, anti-obsessive-compulsive and antibulimic properties. Escitalopram inhibits the reuptake of the neurotransmitter serotonin (5-HT) at the serotonin reuptake pump of the neuronal membrane of the presynaptic cell, thereby increasing levels of 5-HT within the synaptic cleft and enhancing the actions of serotonin on 5HT1A autoreceptors. Unlike other SSRIs, escitalopram appears to not only bind to a primary high-affinity site on the serotonin transporter protein but also to a secondary lower-affinity allosteric site that is considered to stabilize and prolong drug binding. [from NCI]
Escitalopram
 
Gene (location): CYP2C19 (10q23.33)

Definition

Serotonin reuptake inhibitor antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and serotonin modulators with SSRI-like properties are pharmacotherapy options for major depressive and anxiety disorders. Inadequate response and treatment-related adverse events are known challenges in antidepressant therapy. Genetic variations in genes encoding the drug metabolizing enzymes, CYP2D6, CYP2C19 and CYP2B6, have been shown to alter antidepressant biotransformation, which may potentially affect dosing, efficacy, and tolerability. [from PharmGKB]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  

Professional guidelines

PubMed

Management of Menopausal Symptoms: A Review.
Crandall CJ, Mehta JM, Manson JE
JAMA 2023 Feb 7;329(5):405-420. doi: 10.1001/jama.2022.24140. PMID: 36749328
Depression in Children and Adolescents: Evaluation and Treatment.
Selph SS, McDonagh MS
Am Fam Physician 2019 Nov 15;100(10):609-617. PMID: 31730312
Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis.
Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JPT, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JPA, Geddes JR
Lancet 2018 Apr 7;391(10128):1357-1366. Epub 2018 Feb 21 doi: 10.1016/S0140-6736(17)32802-7. PMID: 29477251Free PMC Article

Curated

CPIC® Guideline for Serotonin Reuptake Inhibitor Antidepressants and CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A, 2023

Recent clinical studies

Etiology

Treatment-emergent and trajectory-based peripheral gene expression markers of antidepressant response.
Fiori LM, Orri M, Aouabed Z, Théroux JF, Lin R, Nagy C, Frey BN, Lam RW, MacQueen GM, Milev R, Müller DJ, Parikh SV, Rotzinger S, Uher R, Foster JA, Kennedy SH, Turecki G
Transl Psychiatry 2021 Aug 21;11(1):439. doi: 10.1038/s41398-021-01564-8. PMID: 34420030Free PMC Article
Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder.
Basu A, Chadda R, Sood M, Rizwan SA
Asian J Psychiatr 2017 Aug;28:154-159. Epub 2017 May 15 doi: 10.1016/j.ajp.2017.04.029. PMID: 28784374
Pharmacogenetic Study of Serotonin Transporter and 5HT2A Genotypes in Autism.
Najjar F, Owley T, Mosconi MW, Jacob S, Hur K, Guter SJ, Sweeney JA, Gibbons RD, Cook EH, Bishop JR
J Child Adolesc Psychopharmacol 2015 Aug;25(6):467-74. doi: 10.1089/cap.2014.0158. PMID: 26262902Free PMC Article
Escitalopram and duloxetine in the treatment of major depressive disorder: a pooled analysis of two trials.
Lam RW, Andersen HF, Wade AG
Int Clin Psychopharmacol 2008 Jul;23(4):181-7. doi: 10.1097/YIC.0b013e3282ffdedc. PMID: 18545055

Diagnosis

Metabolomic signatures associated with depression and predictors of antidepressant response in humans: A CAN-BIND-1 report.
Caspani G, Turecki G, Lam RW, Milev RV, Frey BN, MacQueen GM, Müller DJ, Rotzinger S, Kennedy SH, Foster JA, Swann JR
Commun Biol 2021 Jul 22;4(1):903. doi: 10.1038/s42003-021-02421-6. PMID: 34294869Free PMC Article

Therapy

Treatment-emergent and trajectory-based peripheral gene expression markers of antidepressant response.
Fiori LM, Orri M, Aouabed Z, Théroux JF, Lin R, Nagy C, Frey BN, Lam RW, MacQueen GM, Milev R, Müller DJ, Parikh SV, Rotzinger S, Uher R, Foster JA, Kennedy SH, Turecki G
Transl Psychiatry 2021 Aug 21;11(1):439. doi: 10.1038/s41398-021-01564-8. PMID: 34420030Free PMC Article
Clinical, behavioral, and neural measures of reward processing correlate with escitalopram response in depression: a Canadian Biomarker Integration Network in Depression (CAN-BIND-1) Report.
Dunlop K, Rizvi SJ, Kennedy SH, Hassel S, Strother SC, Harris JK, Zamyadi M, Arnott SR, Davis AD, Mansouri F, Schulze L, Ceniti AK, Lam RW, Milev R, Rotzinger S, Foster JA, Frey BN, Parikh SV, Soares CN, Uher R, Turecki G, MacQueen GM, Downar J
Neuropsychopharmacology 2020 Jul;45(8):1390-1397. doi: 10.1038/s41386-020-0688-x. PMID: 32349119Free PMC Article
Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder.
Basu A, Chadda R, Sood M, Rizwan SA
Asian J Psychiatr 2017 Aug;28:154-159. Epub 2017 May 15 doi: 10.1016/j.ajp.2017.04.029. PMID: 28784374
Tumor necrosis factor and its targets in the inflammatory cytokine pathway are identified as putative transcriptomic biomarkers for escitalopram response.
Powell TR, Schalkwyk LC, Heffernan AL, Breen G, Lawrence T, Price T, Farmer AE, Aitchison KJ, Craig IW, Danese A, Lewis C, McGuffin P, Uher R, Tansey KE, D'Souza UM
Eur Neuropsychopharmacol 2013 Sep;23(9):1105-14. Epub 2012 Nov 9 doi: 10.1016/j.euroneuro.2012.09.009. PMID: 23142150
Glycine and a glycine dehydrogenase (GLDC) SNP as citalopram/escitalopram response biomarkers in depression: pharmacometabolomics-informed pharmacogenomics.
Ji Y, Hebbring S, Zhu H, Jenkins GD, Biernacka J, Snyder K, Drews M, Fiehn O, Zeng Z, Schaid D, Mrazek DA, Kaddurah-Daouk R, Weinshilboum RM
Clin Pharmacol Ther 2011 Jan;89(1):97-104. Epub 2010 Nov 24 doi: 10.1038/clpt.2010.250. PMID: 21107318Free PMC Article

Prognosis

Metabolomic signatures associated with depression and predictors of antidepressant response in humans: A CAN-BIND-1 report.
Caspani G, Turecki G, Lam RW, Milev RV, Frey BN, MacQueen GM, Müller DJ, Rotzinger S, Kennedy SH, Foster JA, Swann JR
Commun Biol 2021 Jul 22;4(1):903. doi: 10.1038/s42003-021-02421-6. PMID: 34294869Free PMC Article
Clinical, behavioral, and neural measures of reward processing correlate with escitalopram response in depression: a Canadian Biomarker Integration Network in Depression (CAN-BIND-1) Report.
Dunlop K, Rizvi SJ, Kennedy SH, Hassel S, Strother SC, Harris JK, Zamyadi M, Arnott SR, Davis AD, Mansouri F, Schulze L, Ceniti AK, Lam RW, Milev R, Rotzinger S, Foster JA, Frey BN, Parikh SV, Soares CN, Uher R, Turecki G, MacQueen GM, Downar J
Neuropsychopharmacology 2020 Jul;45(8):1390-1397. doi: 10.1038/s41386-020-0688-x. PMID: 32349119Free PMC Article
Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder.
Basu A, Chadda R, Sood M, Rizwan SA
Asian J Psychiatr 2017 Aug;28:154-159. Epub 2017 May 15 doi: 10.1016/j.ajp.2017.04.029. PMID: 28784374
Pharmacogenetic Study of Serotonin Transporter and 5HT2A Genotypes in Autism.
Najjar F, Owley T, Mosconi MW, Jacob S, Hur K, Guter SJ, Sweeney JA, Gibbons RD, Cook EH, Bishop JR
J Child Adolesc Psychopharmacol 2015 Aug;25(6):467-74. doi: 10.1089/cap.2014.0158. PMID: 26262902Free PMC Article
Tumor necrosis factor and its targets in the inflammatory cytokine pathway are identified as putative transcriptomic biomarkers for escitalopram response.
Powell TR, Schalkwyk LC, Heffernan AL, Breen G, Lawrence T, Price T, Farmer AE, Aitchison KJ, Craig IW, Danese A, Lewis C, McGuffin P, Uher R, Tansey KE, D'Souza UM
Eur Neuropsychopharmacol 2013 Sep;23(9):1105-14. Epub 2012 Nov 9 doi: 10.1016/j.euroneuro.2012.09.009. PMID: 23142150

Clinical prediction guides

Metabolomic signatures associated with depression and predictors of antidepressant response in humans: A CAN-BIND-1 report.
Caspani G, Turecki G, Lam RW, Milev RV, Frey BN, MacQueen GM, Müller DJ, Rotzinger S, Kennedy SH, Foster JA, Swann JR
Commun Biol 2021 Jul 22;4(1):903. doi: 10.1038/s42003-021-02421-6. PMID: 34294869Free PMC Article
Clinical, behavioral, and neural measures of reward processing correlate with escitalopram response in depression: a Canadian Biomarker Integration Network in Depression (CAN-BIND-1) Report.
Dunlop K, Rizvi SJ, Kennedy SH, Hassel S, Strother SC, Harris JK, Zamyadi M, Arnott SR, Davis AD, Mansouri F, Schulze L, Ceniti AK, Lam RW, Milev R, Rotzinger S, Foster JA, Frey BN, Parikh SV, Soares CN, Uher R, Turecki G, MacQueen GM, Downar J
Neuropsychopharmacology 2020 Jul;45(8):1390-1397. doi: 10.1038/s41386-020-0688-x. PMID: 32349119Free PMC Article
Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder.
Basu A, Chadda R, Sood M, Rizwan SA
Asian J Psychiatr 2017 Aug;28:154-159. Epub 2017 May 15 doi: 10.1016/j.ajp.2017.04.029. PMID: 28784374
Tumor necrosis factor and its targets in the inflammatory cytokine pathway are identified as putative transcriptomic biomarkers for escitalopram response.
Powell TR, Schalkwyk LC, Heffernan AL, Breen G, Lawrence T, Price T, Farmer AE, Aitchison KJ, Craig IW, Danese A, Lewis C, McGuffin P, Uher R, Tansey KE, D'Souza UM
Eur Neuropsychopharmacol 2013 Sep;23(9):1105-14. Epub 2012 Nov 9 doi: 10.1016/j.euroneuro.2012.09.009. PMID: 23142150
Glycine and a glycine dehydrogenase (GLDC) SNP as citalopram/escitalopram response biomarkers in depression: pharmacometabolomics-informed pharmacogenomics.
Ji Y, Hebbring S, Zhu H, Jenkins GD, Biernacka J, Snyder K, Drews M, Fiehn O, Zeng Z, Schaid D, Mrazek DA, Kaddurah-Daouk R, Weinshilboum RM
Clin Pharmacol Ther 2011 Jan;89(1):97-104. Epub 2010 Nov 24 doi: 10.1038/clpt.2010.250. PMID: 21107318Free PMC Article

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    • CPIC, 2023
      CPIC® Guideline for Serotonin Reuptake Inhibitor Antidepressants and CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A, 2023

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      Clinical tests in GTR
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      OMIM records containing genes associated with phenotypes registered in MedGen
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