Pharmacogenetics of Fluoxetine; A Review of the Genetic Effects on Its Efficacy and Adverse Effects During Treatment of Major Depressive Disorder

Abstract

Major depressive disorder (MDD) is one of the leading psychiatric disorders which emerge as an important public issue. It drastically affects one's quality of life and causes a substantial decline in social and occupational functioning. Factors like environmental, social, and genetics are thought to be involved in the etiology of MDD. Different treatment options are available for the treatment of MDD. Treatment options include both pharmacological and psychological. Among different pharmacological options, selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed. Fluoxetine was the first SSRI to be approved in the USA for MDD, and since then it has created a good impact in treating MDD.  Fluoxetine is considered effective without producing many of the adverse effects caused by other antidepressants. Despite the fact that fluoxetine is still associated with many side effects many clinicians still prescribe it with the hope of additional antidepressant efficacy compare to other antidepressants. This review focuses on the epidemiology, risk factors, etiology, neurobiology, and treatment options of MDD with special emphasis on the role of fluoxetine. Genetic variants linked with the clinical efficacy and side effects of fluoxetine are reviewed and those with the potential to act as a clinical predictor of therapeutic response and/or side effects are discussed. Recommendations are made for use of some of these genetic variants in clinical medicine.