A new study has found variations in two genes that were more common in depressed patients who developed suicidal thoughts while taking common antidepressants. The genes help make the cell's receptors for glutamate, a chemical messenger in the brain thought to play a part in how antidepressants work.
The study, published in the American Journal of Psychiatry in October 2007, included 1,915 depressed patients who took standard doses of citalopram for 14 weeks. Their blood was tested for variations at 768 sites in 68 genes that might be involved in depression. The genes of the 120 patients who developed suicidal thoughts during the trial were compared with those of patients who didn't.
Patients carrying the variants had a clearly higher rate of suicidal thoughts during treatment, while those with neither variant rarely developed them. Patients who developed suicidal thoughts were also less likely to recover: 25% recovered, against 42% of those without such thoughts.
"These findings need to be repeated before we can recommend genetic testing before treatment, to identify who might be at risk of suicidal thoughts on antidepressants such as citalopram and fluoxetine (Prozac)," says psychiatrist Dr Gonzalo Laje of the National Institute of Mental Health in Bethesda. Anyone starting an antidepressant who has thoughts of self-harm should tell their doctor straight away.
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