Thursday, October 4, 2007

Suicidal on Citalopram

The picture on the right is that of James Torlakson his daughter Elizabeth committed suicide while on Celexa.

I have been tracking this pharmacogenetic issuefor quite sometime now. Ironically, somepeople were at higher risk for suicide while on antidepressants. This had been known for some time with the drugs called SSRIs (selective serotonin reuptake inhibitors) These drugs act on a chemical in the brain which is thought when your levels are low can cause depression even suicide.

The mechanism is unclear as to how this happens. Until now we have not been able to accurately predict who may be at risk. That may soon change

Recently in the journal American Journal of Psychiatry a genetic analysis was performed on the largest study of antidepressant therapy. This study is called the STAR-D trial. There were prior genetic analyses done, but this appears the most promising.

In this analysis it appears that persons taking citalopram(Celexa) that have a change in their GRIK2 gene, called rs2518224 have 8 fold(800%) increased risk of treatment emergent suicidal risk. These are the kinds of Odds Ratios that make me perk up and say hello.

There is a pharmacogenetic test already in existence for this phenomenon. The test called Mark-C is being marketed by a company called NeuroMark and is an example of what more we shall see from labs in this space. I haven't got the specifics of this genetic test, but I have asked for more information on this. I will keep you in the loop.

The Sherpa Says: This is a very important study. However, I always caution that replication is the key to true genetic findings. But this looks pretty promising. I feel horrible for that family. Imagine how this could be prevented. However, similar data was posted on GRIK4 (not quite as good data thought)

1 comment:

Hercules said...

This is the area where pharmacogenomics needs to mature ASAP - helping to keep the "first, do no harm" principal paramount in treatment. The most worry I ever had with my own family and use of prescription drugs was over Accutane, and I was very relieved when time passed and it was noi longer needed.