Impact Of Brand Response On Medication And Abnormal Expression Of Tumor-related Genes In Patients With Depression

OBJECTIVEIn the first part,through investigating the response of drug brand preference and its influence on medication adherence and efficacy in outpatients with depression,we educate them in order to achieve safe,effective and economical rational drug use.In the second part,since many patients with depression are prone to other diseases comorbidity such as tumors,we determine and compare the differential gene expression profile of whole blood among psychological healthy volunteers and patients with depression to explore the relationship between tumor and depression comorbidity.METHODSThis study was approved by the Hospital Ethics Committee.(1)459 outpatients with depression were assessed with drug brand preference questionnaire and medication compliance questionnaire.These patients were divided into the branded drugs group and the domestic generics group according to their current drug use.Patients with high brand preference in branded drugs group were educated with rational use of limited medical resource and pharmacoeconomic knowledge,and then switched with domestic generics for 8 weeks.Safety and efficacy were evaluated both before and after the drug switch.(2)Mental health experts used HAMD scale to screen out the psychological healthy volunteers,as well to enroll outpatients with depression according to the clinical diagnosis and HAMD scale at Mental Health Center.With oral informed content blood samples were collected for of adrenaline,norepinephrine and cortisol in serum determination by ELISA.Differential expression genes,were screened out and verified by RT-PCR.RESULTS(1)Overall,there were about 1/3 of patients have brand response.About 2/3 patients showed low or no brand response.The brand response in the branded drugs groups were slightly higher than that in the generics group,however,the brand response in both groups generally declined with time.The compliance in all patients were not satisfactory,but significant higher in branded drugs group.In branded drugs group,medication compliance was closely related with brand response,but negatively correlated with age and medication course.In domestic generics group,medication compliance was independent of brand response,but closely related with education,negative related with age,and duration.After drug switch with domestic generics patients with brand response,obtained the same antidepressant effect,and no severe adverse reaction occurred.(2)The research of differential expression of tumor-related genes enrolled 90 people(30 psychological healthy volunteers,60 patients with depression).The concentration of adrenaline,norepinephrine and cortisol in serum of patients with depression was significantly reduced.The whole blood microarray suggests that 9948 genes were significantly up-regulated and 8905 genes were significantly down-regulated in patients with depression.Sixteen tumor-related genes were screened out from up-regulation genes and verified by RT-PCR.The expression of tumor-related genes in the patients with depression was higher than that of psychological healthy volunteers.CONCLUSION(1)The compliance in branded drugs group patients show positive correlation with brand response.The medical staff should give medication education to help patients' rational use of limited medical resources.(2)Up-regulation of tumor-related genes suggests that patients with depression are more likely to develop tumors.In addition to regular psychological follow-up in out-patient department,patients are suggested to regular physical examination and early detection of possible cancer.