Predicting the efficacy of escitalopram in the treatment of depression through urinary proteome

Clinically, it takes approximately 12 weeks to assess the effectiveness of antidepressants. We attempted to use the urinary proteome to predict escitalopram efficacy before administration. In this study, urine samples were collected from 20 patients and 9 healthy subjects, patients with good efficacy after 12 weeks of escitalopram (n = 10) and patients with poor efficacy after 12 weeks (n = 10). To highlight the individualized response of each patient to the drug, a one-to-many comparison was used to compare the urinary proteome of a depressed patient with those of a group of healthy people (n = 9) before taking the drug. Differential proteins generated by comparison were used to enrich biological pathways by IPA software. Among the biological pathways, the unique glycine synthesis pathway was present in 6 out of 10 patients in the good efficacy group but not in the poor efficacy patient group. A previous study from the Mayo Clinic showed that glycine and a glycine dehydrogenase (GLDC) SNP are citalopram/escitalopram response biomarkers in MDD. This genetic research is in complete agreement with the results of the urinary proteome, suggesting that the glycine synthesis pathway is more likely to be associated with the efficacy of escitalopram. The urinary proteome has the potential to predict drug efficacy before taking the drug. The biological pathways also include reported antidepressant-related pathways, HIF1α signalling, and serotonin receptor signalling, indicating that the urinary proteome may be used for searching drug targets.