Influence of ABCB1 polymorphisms and serum concentrations on venlafaxine response in patients with major depressive disorder.

BACKGROUND: The pharmacokinetics and the pharmacodynamics of antidepressants show large inter-individual variations which result in unpredictable clinical responses. AIM: The aim of the study was to examine the effect of ABCB1 polymorphisms and the serum concentrations on the efficacy and tolerability of venlafaxine in patients with major depressive disorder (MDD). METHODS: Fifty-two outpatients who met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria for MDD were recruited for the study. The severity of depression was assessed using the 17-item Hamilton Rating Scale for Depression scale (HDRS17) and tolerability was assessed based on a query regarding side-effects for 6 weeks. The ABCB1 C3435T/A and G2677T/A polymorphisms were genotyped by PCR/RFLP and steady-state serum venlafaxine concentrations were measured by high-performance liquid chromatography. RESULTS: Patients with the TT genotype for the C3435T and the TT/TA genotype for the G2677T/A polymorphism showed significantly higher frequencies in venlafaxine-induced akathisia. This relationship was not observed for efficacy. As regards serum venlafaxine concentrations, patient groups showed no significant differences in efficacy and tolerability. CONCLUSION: The results suggest that individuals with the TT-TT/TA genotypes for the C3435T-G2677T/A polymorphisms of ABCB1 may be pre-disposed to a risk of akathisia.

Elevated neutrophil/lymphocyte ratio in patients with schizophrenia.

BACKGROUND: Inflammatory mechanisms are reported to play important roles in the pathophysiology of schizophrenia. The neutrophil-lymphocyte ratio (NLR) is a simple and easily accessible indicator of the systemic inflammatory response. Our goal was to investigate whether NLR was higher in patients with schizophrenia than in healthy comparison subjects similar in age, sex, and body mass index. SUBJECTS AND METHODS: In this multicenter cross-sectional study, we analyzed 156 non-obese patients with schizophrenia and 89 healthy control subjects for complete blood count. The Brief Psychiatric Rating Scale was used to determine the severity of clinical pathology. RESULTS: The mean ± SD NLR of patients with schizophrenia was significantly higher than that of healthy controls (2.6 ± 1.1 vs. 1.9 ± 0.6, respectively, p < 0.001). NLR did not significantly correlate with severity and duration of schizophrenia (r = 0.065. p > 0.05). CONCLUSIONS: Our findings suggest that NLR levels are increased in physically healthy, non-obese, patients with schizophrenia when compared with physically and mentally healthy individuals. To our knowledge, this is the first study that demonstrated the association between NLR and schizophrenia.

The effect of personality disorders on asthma severity and quality of life.

Assesment of health related quality of life (HRQL) is increasingly recognized as an important part of the patient care in asthma. We aimed to evaluate the effect of personality disorders (PDs) on HRQL and the severity of disease in asthmatic patients. Ninety seven consecutive patients with asthma and ninety healthy controls were included. All patients completed a Short Form-36 health survey (SF-36) and Structured Clinical Interview Form for DSM-III-R Axis-II Disorders (SCID-II). All SF-36 questionnaire scores of asthmatic patients were significantly lower than the controls. There were statistical differences between the asthma severity and the mean scores of vitality and emotional role difficulties of HRQL's subdomains (p=0.03, p=0.014, respectively). There was a weak but statistically significant correlation between the scores of pain and emotional role difficulties, and forced expiratory volume in 1 second (FEV1) (r=0.27, p=0.007; r=0.24, p=0.01, respectively). When compared to healthy controls, patients with asthma had higher prevalence of PDs (p=0.0001). The most common PDs found in asthmatic patients were obsessive-compulsive and avoidant PDs. HRQL values of asthma patients with PDs were significantly lower than patients without PDs except for the physical functioning subscores on HRQL. We conclude that patients with asthma have higher prevalence of PDs, which is associated with their poor quality of life. A psychiatric evaluation may be beneficial in patients with asthma if a concomitant PD is suspected.