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Ezenwabachili I, Deumic Shultz E, Mills JA, Ellingrod V, Calarge CA. Examining Whether Genetic Variants Moderate the Skeletal Effects of Selective Serotonin Reuptake Inhibitors in Older Adolescents and Young Adults. J Child Adolesc Psychopharmacol 2023; 33:260-268. [PMID: 37579130 PMCID: PMC10517324 DOI: 10.1089/cap.2023.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Objective: To examine whether serotonin (5-HT) related genetic variants moderate the effects of selective serotonin reuptake inhibitors (SSRIs) on skeletal outcomes. Methods: Trabecular bone mineral density (BMD) at the radius, lumbar spine (LS) BMD, total body less head (TBLH) bone mineral content (BMC) and markers of bone metabolism (osteocalcin, C-terminal telopeptide of type I collagen [CTX-1], and bone specific alkaline phosphatase to CTX-1 ratio) were examined in an observational study, enrolling 15- to 20-year-old participants, unmedicated or within a month of SSRI initiation. Variants in HTR1A (rs6295), HTR1B (rs6296), HTR1D (rs6300), HTR2A (rs6311 and rs6314), HTR2B (rs6736017), and the serotonin transporter intron 2 variable number tandem repeat (STin2 VNTR) were genotyped. Linear mixed-effects regression analysis examined associations between SSRI use, genetic variants, and skeletal outcomes. Results: After adjusting for relevant covariates, rs6295 CC and GC genotypes in 262 participants (60% female, mean ± SD age = 18.9 ± 1.6 years) were significantly associated with higher LS BMD compared to the GG genotype. Rs6311 GG SSRI users had greater LS BMD compared to nonusers (β = 0.18, p = <0.0001). Female SSRI users with the combination of rs6295 CC+GC and rs6311 GG genotypes had greater LS BMD than female SSRI nonusers (β = 0.29, p < 0.0001). SSRI users with the rs6295 GG genotype had higher trabecular BMD compared to nonusers (β = 3.60, p = 0.05). No significant interactions were found for TBLH BMC or bone turnover markers. After correcting for multiple comparisons, none of the results retained significance. Conclusions: In older adolescents and young adults, HTR1A (rs6295) and HTR2A (rs6311) variants may moderate the effect of SSRIs on BMD. Sex differences may exist and require further examination. Further research with larger sample sizes is needed to confirm our preliminary findings. Clinical Trial Registration: clinicaltrials.gov NCT02147184.
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Affiliation(s)
| | | | - James A. Mills
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, USA
| | - Vicki Ellingrod
- College of Pharmacy, The University of Michigan, Ann Arbor, Michigan, USA
| | - Chadi A. Calarge
- Menninger Department of Psychiatry and Behavioral Science and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Yan Y, Park DI, Horn A, Golub M, Turck CW, Golub M, W. Turck C. Delineation of biomarkers and molecular pathways of residual effects of fluoxetine treatment in juvenile rhesus monkeys by proteomic profiling. Zool Res 2023; 44:30-42. [PMID: 36266933 PMCID: PMC9841182 DOI: 10.24272/j.issn.2095-8137.2022.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Fluoxetine (Prozac™) is the only antidepressant approved by the US Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) in children. Despite its considerable efficacy as a selective serotonin reuptake inhibitor, the possible long-term effects of fluoxetine on brain development in children are poorly understood. In the current study, we aimed to delineate molecular mechanisms and protein biomarkers in the brains of juvenile rhesus macaques (Macaca mulatta) one year after the discontinuation of fluoxetine treatment using proteomic and phosphoproteomic profiling. We identified several differences in protein expression and phosphorylation in the dorsolateral prefrontal cortex (DLPFC) and cingulate cortex (CC) that correlated with impulsivity in animals, suggesting that the GABAergic synapse pathway may be affected by fluoxetine treatment. Biomarkers in combination with the identified pathways contribute to a better understanding of the mechanisms underlying the chronic effects of fluoxetine after discontinuation in children.
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Affiliation(s)
- Yu Yan
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Dong Ik Park
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Anja Horn
- Ludwig-Maximilians-Universität, Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, Munich 80336, Germany
| | - Mari Golub
- Department of Environmental Toxicology, University of California, Davis, CA 95616, USA
| | - Christoph W. Turck
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Munich 80804, Germany,E-mail:
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Tkachev A, Stekolshchikova E, Bobrovskiy DM, Anikanov N, Ogurtsova P, Park DI, Horn AKE, Petrova D, Khrameeva E, Golub MS, Turck CW, Khaitovich P. Long-Term Fluoxetine Administration Causes Substantial Lipidome Alteration of the Juvenile Macaque Brain. Int J Mol Sci 2021; 22:ijms22158089. [PMID: 34360852 PMCID: PMC8348031 DOI: 10.3390/ijms22158089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022] Open
Abstract
Fluoxetine is an antidepressant commonly prescribed not only to adults but also to children for the treatment of depression, obsessive-compulsive disorder, and neurodevelopmental disorders. The adverse effects of the long-term treatment reported in some patients, especially in younger individuals, call for a detailed investigation of molecular alterations induced by fluoxetine treatment. Two-year fluoxetine administration to juvenile macaques revealed effects on impulsivity, sleep, social interaction, and peripheral metabolites. Here, we built upon this work by assessing residual effects of fluoxetine administration on the expression of genes and abundance of lipids and polar metabolites in the prelimbic cortex of 10 treated and 11 control macaques representing two monoamine oxidase A (MAOA) genotypes. Analysis of 8871 mRNA transcripts, 3608 lipids, and 1829 polar metabolites revealed substantial alterations of the brain lipid content, including significant abundance changes of 106 lipid features, accompanied by subtle changes in gene expression. Lipid alterations in the drug-treated animals were most evident for polyunsaturated fatty acids (PUFAs). A decrease in PUFAs levels was observed in all quantified lipid classes excluding sphingolipids, which do not usually contain PUFAs, suggesting systemic changes in fatty acid metabolism. Furthermore, the residual effect of the drug on lipid abundances was more pronounced in macaques carrying the MAOA-L genotype, mirroring reported behavioral effects of the treatment. We speculate that a decrease in PUFAs may be associated with adverse effects in depressive patients and could potentially account for the variation in individual response to fluoxetine in young people.
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Affiliation(s)
- Anna Tkachev
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
| | - Elena Stekolshchikova
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
| | - Daniil M. Bobrovskiy
- Faculty of Bioengineering and Bioinformatics, Moscow State University, 119234 Moscow, Russia;
| | - Nickolay Anikanov
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
| | - Polina Ogurtsova
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
| | - Dong Ik Park
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, 80804 Munich, Germany;
| | - Anja K. E. Horn
- Institute of Anatomy and Cell Biology, Ludwig-Maximilians University, 80336 Munich, Germany;
| | - Daria Petrova
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
| | - Ekaterina Khrameeva
- Center of Life Sciences, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia
- Correspondence: (E.K.); (M.S.G.); (C.W.T.); (P.K.)
| | - Mari S. Golub
- California National Primate Research Center, University of California, Davis, CA 95616, USA
- Correspondence: (E.K.); (M.S.G.); (C.W.T.); (P.K.)
| | - Christoph W. Turck
- Proteomics and Biomarkers, Max Planck Institute of Psychiatry, 80804 Munich, Germany;
- Correspondence: (E.K.); (M.S.G.); (C.W.T.); (P.K.)
| | - Philipp Khaitovich
- V. Zelman Center for Neurobiology and Brain Restoration, Skolkovo Institute of Science and Technology, 121205 Moscow, Russia; (A.T.); (E.S.); (N.A.); (P.O.); (D.P.)
- Correspondence: (E.K.); (M.S.G.); (C.W.T.); (P.K.)
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Calarge CA, Mills JA, Karaviti L, Teixeira AL, Zemel BS, Garcia JM. Selective Serotonin Reuptake Inhibitors Reduce Longitudinal Growth in Risperidone-Treated Boys. J Pediatr 2018; 201:245-251. [PMID: 29958671 PMCID: PMC6153035 DOI: 10.1016/j.jpeds.2018.05.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/12/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine whether selective serotonin reuptake inhibitors (SSRIs) inhibit longitudinal growth in children and adolescents, particularly in the early stages of puberty, using a sample of convenience comprising risperidone-treated boys. STUDY DESIGN Data from four clinic-based studies in risperidone-treated 5- to 17-year-old boys with no general medical conditions were combined for this analysis. Anthropometric measurements and psychotropic treatment history were extracted from the medical and pharmacy records. Linear mixed effects regression analyses examined the association between SSRI use and change in age-sex-specific height and body mass index z scores, after adjusting for relevant confounders. RESULTS Risperidone-treated boys (n = 267; age: 12.7 ± 2.7 years), 71% of whom had ever taken an SSRI, contributed to the analysis. After adjusting for age, psychostimulant and antipsychotic use, and time in the study, both the duration of SSRI use as well as the cumulative dose were inversely associated with height z score after age 11 years (P < .0001). After adjusting for baseline height, duration of SSRI use was most strongly inversely associated with height z score in Tanner stages 3 and 4 boys who took SSRIs continuously (r = -0.69, P < .009). No association was observed with body mass index z score. CONCLUSIONS In risperidone-treated boys, SSRI use is associated with reduced longitudinal growth, particularly in those undergoing puberty. Whether adult height or other metabolic or psychological outcomes are affected remains to be determined.
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Affiliation(s)
- Chadi A. Calarge
- Menninger Department of Psychiatry and Behavioral Science and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin Street, Suite 1740, Houston, TX 77030-2399, Tel: 832-824-4764, Fax: 832-825-8981,
| | - James A. Mills
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
| | | | - Antonio L. Teixeira
- Department of Psychiatry, The University of Texas Health Science Center at Houston, Houston, TX
| | - Babette S. Zemel
- Department of Pediatrics, The University of Pennsylvania, Philadelphia, PA
| | - Jose M. Garcia
- Department of Internal Medicine, The University of Washington, Seattle, WA
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Golub MS, Hogrefe CE, Sherwood RJ, Turck CW. Fluoxetine Administration in Juvenile Monkeys: Implications for Pharmacotherapy in Children. Front Pediatr 2018; 6:21. [PMID: 29473029 PMCID: PMC5809484 DOI: 10.3389/fped.2018.00021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/22/2018] [Indexed: 02/03/2023] Open
Abstract
Fluoxetine therapy has been approved for children with major depressive disorder and obsessive compulsive disorder for over 14 years and has expanded to other childhood behavior disorders. As use increases, more detail on fluoxetine effects during juvenile brain development can help maintain safe and effective use of this therapy. Here, a narrative review is provided of previously published findings from a large nonhuman primate project. Fluoxetine was administered to juvenile male rhesus monkeys for an extended period (2 years) prior to puberty. Compared to controls, treated monkeys showed sleep disruption, facilitated social interaction, greater impulsivity, and impaired sustained attention during treatment. No effects on growth were seen. Metabolomics assays characterized a distinctive response to fluoxetine and demonstrated individual differences that were related to the impulsivity measure. Fluoxetine interactions with monoamine oxidase A polymorphisms that influenced behavior and metabolomics markers were an important, previously unrecognized finding of our studies. After treatment was discontinued, some behavioral effects persisted, but short-term memory and cognitive flexibility testing did not show drug effects. This detailed experimental work can contribute to clinical research and continued safe and effective fluoxetine pharmacotherapy in children.
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Affiliation(s)
- Mari S Golub
- California National Primate Research Center, University of California, Davis, Davis, CA, United States
| | - Casey E Hogrefe
- California National Primate Research Center, University of California, Davis, Davis, CA, United States
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Gupta B, Acharya A, Pelekos G, Gopalakrishnan D, Kolokythas A. Selective serotonin reuptake inhibitors and dental implant failure-A significant concern in elders? Gerodontology 2017; 34:505-507. [PMID: 28744899 DOI: 10.1111/ger.12287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Depression is a significantly prevalent health concern in geriatric populations. Selective serotonin reuptake inhibitor drugs (SSRI) are the most commonly prescribed antidepressant agents, with increasing rates of prescription. The present report aimed to present a concise review of the current understanding regarding SSRI effects on bone and dental implant outcomes. MATERIALS AND METHODS A broad-based review and summary of literature pertaining to the effects of SSRI on bone metabolism and on dental implant survival was performed. RESULTS The available literature indicates that serotonin plays a significant role in bone metabolism and experimental reports demonstrate adverse impacts of SSRI on multiple pathways of bone metabolism. Early clinical reports suggest detrimental effects of SSRI on dental implant survival. The type of SSRI drug, dosage and host-related genetic and metabolic factors could be potential modulating factors. There is a paucity of data regarding SSRI usage and dental implant survival specific to geriatric cohorts. CONCLUSION As older individuals comprise a high-risk group for both high oral rehabilitation and SSRI use, clinicians should be aware the potential association between SSRI and dental implant failures. Well-designed investigations specific to geriatric cohorts are essential to understand the implications of SSRI use on dental implant prognosis.
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Affiliation(s)
- Bhumija Gupta
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Aneesha Acharya
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong.,Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Georgios Pelekos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | | | - Antonia Kolokythas
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Cognitive performance of juvenile monkeys after chronic fluoxetine treatment. Dev Cogn Neurosci 2017; 26:52-61. [PMID: 28521247 PMCID: PMC5557667 DOI: 10.1016/j.dcn.2017.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 02/01/2023] Open
Abstract
Potential long term effects on brain development are a concern when drugs are used to treat depression and anxiety in childhood. In this study, male juvenile rhesus monkeys (three-four years of age) were dosed with fluoxetine or vehicle (N=16/group) for two years. Histomorphometric examination of cortical dendritic spines conducted after euthanasia at one year postdosing (N=8/group) suggested a trend toward greater dendritic spine synapse density in prefrontal cortex of the fluoxetine-treated monkeys. During dosing, subjects were trained for automated cognitive testing, and evaluated with a test of sustained attention. After dosing was discontinued, sustained attention, recognition memory and cognitive flexibility were evaluated. Sustained attention was affected by fluoxetine, both during and after dosing, as indexed by omission errors. Response accuracy was not affected by fluoxetine in post-dosing recognition memory and cognitive flexibility tests, but formerly fluoxetine-treated monkeys compared to vehicle controls had more missed trial initiations and choices during testing. Drug treatment also interacted with genetic and environmental variables: MAOA genotype (high- and low transcription rate polymorphisms) and testing location (upper or lower tier of cages). Altered development of top-down cortical regulation of effortful attention may be relevant to this pattern of cognitive test performance after juvenile fluoxetine treatment.
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Laurent L, Huang C, Ernest SR, Berard A, Vaillancourt C, Hales BF. Response to letter to the editor by Wise. ACTA ACUST UNITED AC 2016; 106:1059-1061. [PMID: 27900843 DOI: 10.1002/bdra.23580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Chunwei Huang
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Sheila R Ernest
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Anick Berard
- Faculty of Pharmacy, University of Montreal, and Research Center, CHU Sainte-Justine Montreal, QC, Canada
| | | | - Barbara F Hales
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
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Golub MS, Hogrefe CE, Bulleri AM. Regulation of emotional response in juvenile monkeys treated with fluoxetine: MAOA interactions. Eur Neuropsychopharmacol 2016; 26:1920-1929. [PMID: 27852517 PMCID: PMC5154301 DOI: 10.1016/j.euroneuro.2016.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 10/10/2016] [Accepted: 10/29/2016] [Indexed: 01/23/2023]
Abstract
Juvenile male rhesus macaques received therapeutic doses of fluoxetine daily from one to three years of age and were compared to vehicle-treated controls (N=16/group). Genotyping for monoamine oxidase A (MAOA) polymorphisms was used to form subgroups (N=8) with high and low expression of the gene. Behavioral responses were scored during 30-second exposures to pictures differing in affective content. As expected from its therapeutic effect, fluoxetine decreased the behavioral response to emotionally evocative pictures. A 44% reduction in number of expressive behaviors was seen, but only in subjects with low expression MAOA polymorphisms. In general, this effect occurred for pictures of varying affective content and was not due to altered occurrence of one specific behavior or type of behavior. The drug*genotype interaction was seen after one and two years of treatment and did not reverse one year after discontinuation of dosing. Two potential translational implications are suggested: (1) MAOA genetic polymorphisms may be the source of some of the variability in response to fluoxetine treatment in children; (2) extended fluoxetine treatment during juvenile brain development may result in persistent effects on emotional regulation.
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Affiliation(s)
- M S Golub
- University of California Davis, Department of Environmental Toxicology, Davis, California, USA.
| | - C E Hogrefe
- University of California Davis, California National Primate Research Center, Davis, California, USA
| | - A M Bulleri
- University of California Davis, California National Primate Research Center, Davis, California, USA
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Su SY, Hogrefe-Phi CE, Asara JM, Turck CW, Golub MS. Peripheral fibroblast metabolic pathway alterations in juvenile rhesus monkeys undergoing long-term fluoxetine administration. Eur Neuropsychopharmacol 2016; 26:1110-8. [PMID: 27084303 PMCID: PMC5590669 DOI: 10.1016/j.euroneuro.2016.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/03/2016] [Accepted: 03/24/2016] [Indexed: 02/07/2023]
Abstract
We report on biochemical pathways perturbed upon chronic fluoxetine administration to juvenile macaques using global metabolomics analyses of fibroblasts derived from skin biopsies. After exposure to tissue culture conditions confounding environmental factors are eliminated and identification of metabolites whose levels are affected by the drug become apparent with a better signal-to-noise ratio compared to data obtained from plasma and cerebrospinal fluid (CSF). Levels of more than 200 metabolites were analyzed to interrogate affected molecular pathways and identify biomarkers of drug response. In addition, we have correlated the metabolomics results with monoamine oxidase (MAOA) genotype and impulsivity behavioral data. Affected pathways include Purine and Pyrimidine metabolisms that have been previously implicated to contribute to neuropsychiatric disorders.
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Affiliation(s)
- Shu-Yi Su
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany
| | - Casey E Hogrefe-Phi
- California National Primate Research Center, University of California, Davis, USA
| | - John M Asara
- Division of Signal Transduction, Beth Israel Deaconess Medical Center, and Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Christoph W Turck
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany.
| | - Mari S Golub
- Department of Environmental Toxicology, University of California, Davis, USA.
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