Project Summary

Greer M. Murphy, Jr., M.D., Ph.D. (Independent Investigator 2002) of Stanford University, is seeking to develop a method for identifying individuals at risk for medication side effects or for poor therapeutic response, which would be especially helpful for elderly depressed patients as the margin for prescribing error in the elderly is small. Dr. Murphy has performed the first large-scale prospective pharmacogenetic study of antidepressant efficacy and side effects in the elderly, and he will use this clinical and genetic information to discover how variation among patients in genes involved in the actions of mirtazapine and paroxetine (two widely prescribed antidepressant medications) affects treatment outcome. Therapeutic efficacy and side effects of these medications are due to their interactions with neurons that utilize the neurotransmitters serotonin and norepinephrine. He will target genes encoding serotonin and norepinephrine receptors and transporter proteins. Variation in these genes influences the function of receptors and transporters in the brain, which may influence the efficacy and side effects of paroxetine and mirtazapine. By identifying patients at risk for poor outcome before treatment is initiated, patient suffering and wasted health care dollars can be minimized.

Program Area: MOOD DISORDERS\Depression (Unipolar)\Pharmacology

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