LEPR Polymorphism Weight Gain by Mirtazapine in Late Life Depression

Does LEPR Polymorphism Predict Variability in Weight Gain Induced by Mirtazapine in the Treatment of Late Life Depression?

Patients with an episode of depression in late life prescribed mirtazapine recruited from a clinical sample will be monitored for weight and receive a blood test during their usual course of treatment to determine polymorphisms in a specific gene (LEPR) thought to affect weight gain.

Inclusion Criteria:

• patients older than 50 years
• meeting criteria for a diagnosis of major depressive disorder (DSM IV code 296.2x or 296.3x) as confirmed by a score > 20 on the HAM-D 24 items scale and a structured clinical interview using the SCID by a consultant psychiatrist

Exclusion Criteria:

• Treatment resistant depression (as defined by failure to respond to ≥2 adequate antidepressant trials)
• Major depressive disorder with psychosis (296.x4)
• Those with depression who fulfill the chronic specifier (MDE for >2 years)
• Significant Axis II pathology
• Previous trial with mirtazapine
• Concurrent antipsychotic usage
• Comorbid dementia (as confirmed by MMSE < 24)
• Substance misuse including drug and/or alcohol dependence/abuse in the past 3 months
• Bipolar disorder
• Schizophrenia
• Obsessive compulsive disorder
• Post traumatic stress disorder
• Eating disorder
• Head injury
• Recent stroke (< 3 months)
• Recent MI (< 3 months)
• Currently actively participating in structured/formal psychotherapy
• Being non ambulatory
• Those actively suicidal
• Those incapable of informed consent