Skip to content

Research at St Andrews

Does the 5-HT1A rs6295 polymorphism influence the safety and efficacy of citalopram therapy in the oldest old?

Research output: Contribution to journalArticle


Greg Scutt, Andrew Overall, Railton Scott, Bhavik Patel, Lamia Hachoumi, Mark Yeoman, Juliet Wright

School/Research organisations


Major depressive disorder (MDD) in older people is a relatively common, yet hard to treat problem. In this study, we aimed to establish if a single nucleotide polymorphism in the 5-HT1A receptor gene (rs6295) determines antidepressant response in patients aged > 80 years (the oldest old) with MDD.

Nineteen patients aged at least 80 years with a new diagnosis of MDD were monitored for response to citalopram 20 mg daily over 4 weeks and genotyped for the rs6295 allele. Both a frequentist and Bayesian analysis was performed on the data. Bayesian analysis answered the clinically relevant question: ‘What is the probability that an older patient would enter remission after commencing selective serotonin reuptake inhibitor (SSRI) treatment, conditional on their rs6295 genotype?’

Individuals with a CC (cytosine–cytosine) genotype showed a significant improvement in their Geriatric Depression Score (p = 0.020) and cognition (p = 0.035) compared with other genotypes. From a Bayesian perspective, we updated reports of antidepressant efficacy in older people with our data and calculated that the 4-week relative risk of entering remission, given a CC genotype, is 1.9 [95% highest-density interval (HDI) 0.7–3.5], compared with 0.52 (95% HDI 0.1–1.0) for the CG (cytosine–guanine) genotype. The sample size of n = 19 is too small to draw any firm conclusions, however, the data suggest a trend indicative of a relationship between the rs6295 genotype and response to citalopram in older patients, which requires further investigation.



Original languageEnglish
Pages (from-to)355-366
Number of pages12
JournalTherapeutic Advances in Drug Safety
Issue number7
Early online date23 Apr 2018
Publication statusPublished - 1 Jul 2018

    Research areas

  • ageing, Bayesian analysis, depression, pharmacogenomics

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Does age matter? The impact of rodent age on study outcomes

    Jackson, S. J., Andrews, N., Ball, D., Bellantuono, I., Gray, J., Hachoumi, L., Holmes, A., Latcham, J., Petrie, A., Potter, P., Rice, A., Ritchie, A., Stewart, M., Strepka, C., Yeoman, M. & Chapman, K., 1 Apr 2017, In : Laboratory Animals. 51, 2, p. 160-169 10 p.

    Research output: Contribution to journalArticle

  2. Electrochemical sensor for the detection of multiple reactive oxygen and nitrogen species from ageing central nervous system homogenates

    Fagan-Murphy, A., Hachoumi, L., Yeoman, M. S. & Patel, B. A., Dec 2016, In : Mechanisms of Ageing and Development. 160, p. 28-31 4 p.

    Research output: Contribution to journalArticle

ID: 255222993