Antidepressant-Induced Apathy in Adolescents with a Depressive Episode While Taking Sertraline: Results of 8-Week Observational Study with Pharmacogenetic Testing for <em>CYP2C19</em>

Objectives. To investigate the risk of developing emotional blunting in adolescents with a depressive episode who are prescribed sertraline. To establish associations of carriage of CYP2C19 gene polymorphisms with the antidepressant-induced apathy. Methods. The study included 133 adolescents (89.5% female) aged 12-17 who were prescribed sertraline. The follow-up was carried out for 8 weeks. Emotional blunting was assessed using the Oxford Depression Questionnaire scale (ODQ-26) at the time of activation, after one, three and 8 weeks. We took into account the appointment of additional pharmacotherapy. The polymorphisms CYP2C19*2, *3, *17 were genotyped for all patients. Based on the results of genotyping, the phenotypes of the CYP2C19 isoenzyme were determined. Results. The ODQ score at the time of enrollment was higher (65 [50;79]) compared to after 8 weeks (38 [32;53]). The part 3 of the ODQ-26 questionnaire remained approximately the same for 8 weeks. Patients with higher ODQ-26 values at enrollment (73 [56;83] vs. 59 [44;71], p=0.0006) were more likely to be prescribed antipsychotics. Differences in ODQ scores remained significant up to 3 weeks after enrollment (50.5 [41.5;68], vs. 45.5 [36;54], p=0.015). The comparison of ODQ scores and their dynamics did not show significant differences depending on CYP2C19*2 or *17 polymorphisms, or the type of CYP2C19 metabolism. Conclusion. A negative outcome was observed: there was no improvement in emotional blunting among adolescents with depression who took sertraline for eight weeks. No significant correlations were found between the carriage of CYP2C19 gene variants and the development of apathy induced by antidepressants.