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Vol 59(2025) N 6 p. 943-950; DOI 10.1134/S0026893325700384 Full Text

A.E. Gareeva1,2*, T.R. Nasibullin1, S.A. Pozdnyakov3, L.S. Borodina4, I.F. Timerbulatov2, N.V. Baymeeva5, D.E. Bagaev6,7, V.V. Smirnov6,7

Personalized Pharmacotherapy with Sertraline in Patients with Anxiety-Depressive Disorder Based on Omics Biomarkers

1Institute of Biochemistry and Genetics, Ufa Federal Research Center, Russian Academy of Sciences, Ufa, 450054 Russia
2Russian Medical Academy of Continuing Professional Education of the Ministry of Health of Russia, Moscow, 125993 Russia
3Moscow Scientific and Practical Center of Narcology of the Moscow City Health Department, Moscow, 109390 Russia
4Republican Narcological Dispensary of the Ministry of Health of the Republic of Bashkortostan no. 1, Ufa, 450057 Russia
5Scientific Center for Mental Health, Moscow, 115522 Russia
6State Scientific Center Institute of Immunology, Federal Medical and Biological Agency, Moscow, 115522 Russia
7Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991 Russia


*annagareeva@yandex.ru
Received - 2025-04-30; Revised - 2025-05-28; Accepted - 2025-06-26

Sertraline, a selective serotonin reuptake inhibitor, is widely used as a first-line drug for anxiety and depressive disorders. The clinical efficacy and adverse reactions observed with antidepressants are closely related to the concentration of this drug in the patient's blood, but the vast majority of antidepressants demonstrate significant pharmacokinetic variability, leading to pronounced interindividual differences in the steady-state concentration of the drug in the blood and its efficacy even with the same dosing regimen. In this regard, it has become obvious that genetic markers alone are not enough to obtain the most complete profile of the efficacy and safety of a drug; a combination of genotyping methods with omics biomarkers is necessary. As a result of examination of patients, residents of the Republic of Bashkortostan, that had been diagnosed with mixed anxiety-depressive disorder (F41.2), it was found that polymorphic variants rs16947 (CYP2D6*2), rs389209 (CYP2D6*4), and rs1065852 (CYP2D6*10) of the CYP2D6gene do not have a significant effect on the activity of CYP2D6. Genetically determined variations in the activity of the CYP2D6 isoenzyme lead to differences in the metabolism of sertraline and its active metabolite N-desmethylsertraline in different patients, which causes variability in their concentrations in the blood plasma. A statistically significant increase in the plasma concentrations of sertraline and N-desmethylsertraline was found in patients carrying the slow allelic variants rs3892097, rs1065852, and rs16947 of the CYP2D6 gene. A statistically significant moderate inverse correlation was found between the dose and the metabolic ratio C6-HO-THBC/CP. The results obtained are preliminary, which makes it necessary to continue this study with an expanded sample size.

sertraline, selective serotonin reuptake inhibitors, pharmacogenetics, phenotyping, CYP2D6 gene, polymorphic variants



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