Evidence map›Paper›PMID 37683232›Full record

SynthesisJournal of clinical psychopharmacology

Antidepressant-Associated Treatment Emergent Mania: A Meta-Analysis to Guide Risk Modeling Pharmacogenomic Targets of Potential Clinical Value.

Nicolas A Nuñez, Brandon J Coombes, Lindsay Melhuish Beaupre, Francisco Romo-Nava, Manuel Gardea-Resendez, Aysegul Ozerdem, Marin Veldic, Balwinder Singh, Jorge A Sanchez Ruiz, Alfredo Cuellar-Barboza and 5 more

Open access · hybridAbstract readMeta-AnalysisReview
In one paragraph

Synthesis in Journal of clinical psychopharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 3 countries.

Nicolas A NuñezFrom the Departments of Psychiatry and Psychology.
Brandon J CoombesQuantitative Health Sciences, Mayo Clinic, Rochester, MN.
Lindsay Melhuish BeaupreQuantitative Health Sciences, Mayo Clinic, Rochester, MN.
Francisco Romo-NavaLindner Center of HOPE/University of Cincinnati, Cincinnati, OH.
Manuel Gardea-ResendezDepartment of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México.
Aysegul OzerdemFrom the Departments of Psychiatry and Psychology.
Marin VeldicFrom the Departments of Psychiatry and Psychology.
Balwinder SinghFrom the Departments of Psychiatry and Psychology.
Jorge A Sanchez RuizFrom the Departments of Psychiatry and Psychology.
Alfredo Cuellar-BarbozaDepartment of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México.
Jonathan G LeungDepartment of Pharmacy, Mayo Clinic, Rochester, MN.
Miguel L PrietoDepartment of Psychiatry, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile.
Susan L McElroyDepartment of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México.
Joanna M Biernacka
Mark A FryeFrom the Departments of Psychiatry and Psychology.
Universidad de Los Andes, Chile · CLCreative Commons · USMayo Clinic in Arizona · USMayo Clinic in Florida · USLindner Center of HOPE · USUniversity of Cincinnati · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe purpose of this study was to review the association between the SLC6A4 5-HTTLPR polymorphism and antidepressant (AD)-associated treatment emergent mania (TEM) in bipolar disorder alongside starting a discussion on the merits of developing risk stratification models to guide when not to provide AD treatment for bipolar depression.

methodsStudies that examined the association between clinical and genetic risk factors, specifically monoaminergic transporter genetic variation, and TEM were identified. A meta-analysis was performed using the odds ratio to estimate the effect size under the Der-Simonian and Laird model.

resultsSeven studies, referencing the SLC6A4 5-HTTLPR polymorphism and TEM (total N = 1578; TEM+ =594, TEM- = 984), of 142 identified articles were included. The time duration between the start of the AD to emergence of TEM ranged from 4 to 12 weeks. There was a nominally significant association between the s allele of the 5-HTTLPR polymorphism and TEM (odds ratio, 1.434; 95% confidence interval, 1.001-2.055; P = 0.0493; I2 = 52%). No studies have investigated norepinephrine or dopamine transporters.

conclusionAlthough the serotonin transporter genetic variation is commercially available in pharmacogenomic decision support tools, greater efforts, more broadly, should focus on complete genome-wide approaches to determine genetic variants that may contribute to TEM. Moreover, these data are exemplary to the merits of developing risk stratification models, which include both clinical and biological risk factors, to guide when not to use ADs in bipolar disorder. Future studies will need to validate new risk models that best inform the development of personalized medicine best practices treating bipolar depression.

Indexed as

Bipolar DisorderManiaAntidepressive AgentsHumansPharmacogeneticsPolymorphism, GeneticSerotonin Plasma Membrane Transport ProteinsAntidepressive AgentsSerotonin Plasma Membrane Transport ProteinsSLC6A4 protein, human

Identifiers

PMID37683232
PMCPMC10476595
OpenAlexW4385850569

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.