Suicide cases and venlafaxine

Piatkov I, Jones T, Van Vuuren RJ. Suicide cases and venlafaxine. Objective: Our aim was to establish whether the presence or absence of fully functioning cytochrome P450 2D6, 2C19 and 2C9 genetic alleles was associated with suicide in patients receiving venlafaxine treatment. Method: Authorisation from the NSW State Coroner to perform post-mortem genetic testing was obtained for 11 samples from deceased persons who committed suicide during treatment with venlafaxine (VENADR study). Results: All patients, but one, have at least one copy of the loss-of-function, altered or decreased cytochrome P450 enzyme activity allele. Four patients' results reveal loss-of-function genotypes, while all others were found to have diminished enzyme activity polymorphisms. Seven patients had multiple altered function polymorphisms, which included CYP2D6, CYP2C19 or CYP2C9. Conclusion: Our preliminary limited data show that neurotoxicity development, which manifests as suicide while on venlafaxine treatment, probably correlates with a higher prevalence of gene copies of altered functioning cytochrome P450 genetic polymorphisms.