Analysis of SLC6A4 (5 ‑HTTLPR) gene polymorphism depending on clinical features and efficacy of therapeutic and rehabilitation measures in patients with psychostimulant addiction
Authors:   SBHI Moscow Research and Practical Centre for Narcology of the Moscow Healthcare Department, Moscow, Russia, Poplevchenkov К. N. , Agibalova T. V. ,   SBHI Moscow Research and Practical Centre for Narcology of the Moscow Healthcare Department, Moscow, Russia; Peoples' Friendship University of Russia named after P. Lumumba, Moscow, FSBEI CPE Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia, Buzik O. Zh. ,   SBHI Moscow Research and Practical Centre for Narcology of the Moscow Healthcare Department, Moscow, Russia; FSBEI CPE Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia, Masyakin A. V. ,   SBHI Moscow Research and Practical Centre for Narcology of the Moscow Healthcare Department, Moscow, Russia, FSBI CPE Central State Medical Academy of the Presidential Administration of the Russian Federation,
Published: April 2024

The annual increase in the number of patients with psychostimulant addiction and the low duration of remissions as a result of treatment of such disorders prompt researchers to search for new approaches to therapy. It seems relevant to search for and introduce into practice new clinical and genetic markers that increase the effectiveness of psychostimulant addiction therapy within the framework of a personalized approach. The purpose of the study is to determine the impact of a number of clinical characteristics and SLC6A4 (5‑HTTLPR) gene polymorphism on the efficacy of treatment and rehabilitation program in patients with psychostimulant addiction. Materials and methods. The study included 325 patients diagnosed with «mental and behavioral disorders due to use of psychostimulants» (F14.2, F15.2, F19.2 according to ICD-10); men and women aged 18 to 50 years, ethnically Russian, signed informed consent to participate in the study. Methods: clinical-psychopathological, anamnestic, molecular-genetic, psychometric (Montgomery — Åsberg Depression Rating Scale (MADRS)), and statistical methods. Results. All patients were divided into groups depending on the psychoactive substances used and comorbid psychiatric pathology. It was found that SSRI monotherapy (Escitalopram) for the relief of affective disorders in the post-withdrawal period was most effective in the patients who used only psychostimulants (p<0.005). Combined psychopharmacotherapy was more efficient in other groups (p<0.001). The patients with SS and SL genotypes of the SLC6A4 (5‑HTTLPR) gene tolerated Escitalopram monotherapy worse; a statistical difference was achieved for the patients with LL and SL/SS genotypes of group 2 (p<0.036). There were more patients who passed the rehabilitation program and with the longest remissions among those with the SL and SS genotypes of the SLC6A4 (5‑HTTLPR) gene in all groups. Conclusion. After analyzing the results, the conclusions about the association between a number of clinical and genetic characteristics of patients with psychostimulant addiction and the effectiveness of treatment and rehabilitation measures were drawn.