Escitalopram Pharmacogenetics: What Does the Evidence Suggest?

Abstract

Depression is among the most diagnosed mental health conditions. It affects how a person thinks, feels, and behaves. It can impact anyone at any age and deprive one of physical and emotional life force. In the post-COVID-19 world, depression has become even more prevalent and pervasive. While scientists are actively trying to track the pathophysiology of depression, for now, it remains to be fully understood. Escitalopram, the enantiomer of citalopram, is widely prescribed for treating anxiety, depression, obsessive-compulsive disorder (OCD), etc. It is a potent selective serotonin reuptake inhibitor (SSRI), but its effect is varied in different individuals, as therapeutic failures are common with antidepressants. Pharmacogenomics can help with tailoring effective therapeutic strategies by defining biomarkers to classify responders and non-responders, minimizing the risk of side effects and adverse events. For escitalopram, genes like SCL6A4 rs25531, ABCB1 rs1045642, and CYP2C19*17 rs12248560 were associated with optimal therapeutic response, with better remission rates at lower doses. These findings can be utilized for curating effective patient-centric therapeutic strategies.