A study published in BMCMedicine reports that weight gain in patients on the antidepressant citalopram was associated with poor or intermediate CYP2C19 metabolizer status.
poor metabolizers compared to normal metabolizers, there is an implied risk of adverse outcomes, and the recommendation is to reduce the citalopram dose by 50% [
]. Further studies are needed to evaluate drug blood concentrations and weight gain according to metabolizer status. Our study has some limitations. First, the low prevalence of some CYP enzyme phenotypes and the small sample size might cause a type II error in assessing our primary outcome. This limits the ability to detect a difference in TBWG % with other enzyme phenotypes. Importantly, given the nature of the study, we could not include all patients prescribed an SSRI because a few had no follow up at our institution.
In addition to the CYP genes, other genes related to the serotonin and norepinephrine signaling have been implicated with the therapeutic responses to SSRI.
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