International Journal of Clinical Pharmacy

, Volume 38, Issue 2, pp 388–394 | Cite as

Influence of CYP2B6 and CYP2C19 polymorphisms on sertraline metabolism in major depression patients

  • Nazan Yuce-Artun
  • Bora Baskak
  • Erguvan Tugba Ozel-Kizil
  • Hatice Ozdemir
  • Zuhal Uckun
  • Halise Devrimci-Ozguven
  • Halit Sinan SuzenEmail author
Research Article


Background Genetic polymorphisms in CYP2B6 and CYP2C19 may cause variability in the metabolism of sertraline, a widely used antidepressant in major depressive disorder treatment. Objective This study investigates the impact of CYP2B6*4 (785A > G), CYP2B6*9 (516G > T), CYP2B6*6 (516G > T + 685G > A) CYP2C19*2 (685G > A), CYP2C19*17 (−3402C > T) polymorphisms on plasma concentrations of sertraline and N-desmethyl sertraline in major depression patients treated with sertraline [n = 50]. Setting Participants were patients who admitted to an adult psychiatry outpatient unit at a university hospital. These were DSM-IV major depression diagnosed patients with a stable sertraline medication regimen [for at least one month]. Methods CYP2B6*4 (rs 2279343; 785A > G), CYP2B6*9 (516G > T; rs 3745274), CYP2B6*6 (516G > T + 685G > A) CYP2C19*2 (rs 4244285; 685G > A), CYP2C19*17 (rs 11188072; −3402C > T), polymorphisms were analyzed by polymerase chain reaction and restriction fragment length polymorphism. Plasma concentrations were measured by high-performance liquid chromatography in patients treated with SERT. Main outcome measure The distribution of CYP2B6*4, *6, *9 and CYP2C19*2, *17 among patient group and the association between genotype and sertraline metabolism. Results Sertraline, N-desmethyl sertraline, N-desmethyl sertraline/sertraline and dose-adjusted plasma concentrations were statistically compared between individuals with wild-type and variant alleles both for CYP2B6 and CYP2C19 enzymes. The mean N-desmethyl sertraline/sertraline value, was significantly lower in all subgroups with *6 and *9 variant alleles (p < 0.05). Sertraline/C values were significantly higher (p <  0.05) and N-desmethyl sertraline/C values were lower in all subgroups with *6 and *9 variant alleles compared to wild-type subgroup. Conclusion CYP2B6*6 and *9 variant alleles had a significant decreasing effect on sertraline metabolism in major depression patients which might result as variations in sertraline therapy.


CYP2B6 CYP2C19 Cytochrome P450 Sertraline Pharmacogenetics 



We acknowledge nurses for the skilled assistance during blood collection in the psychiatry departments.


This work was supported by The Scientific and Technological Research Council of Turkey under Project 109S147.

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Nazan Yuce-Artun
    • 1
  • Bora Baskak
    • 2
  • Erguvan Tugba Ozel-Kizil
    • 2
  • Hatice Ozdemir
    • 3
  • Zuhal Uckun
    • 4
  • Halise Devrimci-Ozguven
    • 5
  • Halit Sinan Suzen
    • 5
    Email author
  1. 1.Biotechnology InstituteAnkara UniversityAnkaraTurkey
  2. 2.School of Medicine, Psychiatry DepartmentAnkara UniversityAnkaraTurkey
  3. 3.School of Medicine, Psychiatry DepartmentKirikkale UniversityKirikkaleTurkey
  4. 4.Faculty of Pharmacy, Department of ToxicologyMersin UniversityMersinTurkey
  5. 5.Faculty of Pharmacy, Department of ToxicologyAnkara UniversityTandogan, AnkaraTurkey

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