Influence of 5-HTR2A genetic polymorphisms on the efficacy of antidepressants in the treatment of major depressive disorder: a meta-analysis

Objective: The aim of the current meta-analysis was to assess the influence of common genetic polymorphisms in the 5-HTR2A gene on the efficacy of antidepressants in the treatment of major depressive disorder (MDD).

Method: MEDLINE (1966-2013), Cochrane Library Database (Issue 12, 2013), EMBASE (1980-2013), CINAHL (1982-2013), Web of Science (1945-2013) and Chinese Biomedical Database (CBM) (1982-2013) were searched without language restrictions. Meta-analysis was performed using the STATA statistical software. We calculated the odds ratio (OR) and its 95% confidence interval (95% CI) to estimate the efficacy of antidepressants in the treatment of MDD.

Results: Eleven studies with a total of 1775 MDD patients met the inclusion criteria of this meta-analysis. Three common polymorphisms in the 5-HTR2A gene were assessed, including rs6311 C>T, rs7997012 G>A, and rs6313 T>C. Our findings suggested that the 5-HTR2A rs6313 T>C polymorphism was significantly correlated with a higher response rate to antidepressants in MDD patients (allele model: OR=1.33, 95% CI=1.05-1.68, P=0.020; dominant model: OR=1.62, 95% CI=1.21-2.18, P=0.001; homozygous model: OR=1.85, 95% CI=1.18-2.90, P=0.008). The rs7997012 G>A polymorphism was also associated with a higher response rate to antidepressants in MDD patients under the dominant model (OR=1.92, 95% CI=1.02-3.61, P=0.044). However, no significant correlation was found for the 5-HTR2A rs6311 C>T polymorphism under five genetic models (all P>0.05).

Conclusion: Our findings provide empirical evidence that the 5-HTR2A rs6313 T>C and rs7997012 G>A polymorphism may be correlated with the efficacy of antidepressants in the treatment of MDD.