Mental illness affects an estimated 1.2 million children and adolescents in Canada, and approximately 20% of Canadians will have developed a mental illness by age 25. In Manitoba, 14% of children aged 6 to 19 years were diagnosed with a mental disorder between 2010 and 2013. Major depressive disorder (MMD), anxiety disorders, and obsessive-compulsive disorder (OCD) are among the most common mental health disorders in children. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are frequently prescribed for these children. Although these medications are generally effective and safe, some children suffer from adverse effects. One such adverse effect is behavioural activation, characterized by hyperactivity, impulsivity, or irritability. Unfortunately, we do not currently know why some children develop behavioural activation while others do not. The proposed project aims to identify a panel of genetic variants that could assist clinicians in detecting children at-risk for developing this adverse effect. The success of the study could ultimately impact how antidepressants are prescribed to children by giving healthcare providers and parents a personalized solution to assessing the risk for antidepressant-induced behavioural activation. In turn, this would substantially reduce the distress experienced by patients and their families and alleviate the economic costs associated with managing this adverse effect.
Objectives and Aims: The proposed study aims to identify and validate a panel of genetic markers associated with SSRI-induced behavioural activation in children and adolescents with MDD, anxiety disorders, or OCD that could ultimately be used clinically to reduce the incidence of this adverse event and improve health outcomes.
To achieve this objective, we propose two aims:
To recruit and collect DNA from children and adolescents (age 6 – 17 years) who developed (cases, n = 50) or did not develop (controls, n = 50) behavioural activation after taking an SSRI over an 18-month recruitment period and be genotyped using a comprehensive pharmacogenomic array to discover genomic markers associated with SSRI-induced behavioural activation.
To replicate the findings in aim one by comparing genomic variants of interest to those identified in an independent cohort of children and adolescents (age 6 – 17 years) (n = 60) with SSRI-induced behavioural activation from the University of Calgary.
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Team:
Principal Investigator: Abdullah Al Maruf, PhD, M.Pharm (University of Manitoba)
Co-Investigators/Collaborators: Laurence Katz, MD, FRCPC (University of Manitoba) Cara Catz, MD, FRCPC (University of Manitoba) Geert ‘t Jong, MD, PhD (University of Manitoba) Alexander Singer, MB BAO BCh, CCFP (University of Manitoba) Jessica Hartley, MS, CGC (University of Manitoba) Kaarina Kowalec, MSc, PhD (University of Manitoba) Anna Chudyk, MSc, PhD (University of Manitoba) Christine Leong, PharmD, MSc, PhD (University of Manitoba) Terry Klassen, MD, MSc, FRCPC (University of Saskatchewan) Chad Bousman, PhD, MPH (University of Calgary) Paul Arnold, MD, PhD, FRCPC (University of Calgary)
Research Pharmacist: Anju Sareen, BSc(Pharm), RPh (University of Manitoba)
Research Nurse: Laina McAusland, RN, MSc (University of Calgary)
Clinical Research Coordinator: Madison Heintz, MSW, RSW (University of Calgary)
Research Assistants: Nuzhat Tabassum, MSc Student (University of Manitoba) Grace Pilkey, PharmD Student (University of Manitoba) Haley Charbonneau, PharmD Student (University of Manitoba)
Recruitment materials are prepared by Grace Pilkey.