Drugs affected by COMT
About COMT
COMT inactivates the brain's catecholamines (dopamine, norepinephrine, and epinephrine), especially in the prefrontal cortex. A very common variant (Val158Met, rs4680) reduces enzyme activity about three- to four-fold. Met/Met carriers maintain higher prefrontal dopamine, which has been linked, with varying effect size, to differences in stress response, working memory, and pain sensitivity.[1]
COMT is one of the most-studied behavioral genetics targets but the effects on any single drug response are modest. Researchers continue to investigate its role in opioid analgesia and chronic pain syndromes.
What we test for COMT
Gene2Rx uses definitions covering 2 named COMT alleles, built from 1 variant in Gene2Rx definitions. Results depend on the variants available in your upload.
- Named alleles
- 2
- Defined variants
- 1
- Source
- Gene2Rx definitions
- Genome build
- GRCh38
- Normal Function 1
- Decreased Function 1
What do these allele names mean?
COMT alleles are named by the underlying DNA variant rather than a star number. For example, c.61C>T describes a single base change at position 61 of the coding sequence.
DNA variant labels identify sequence differences. Their interpretation depends on the particular gene, the evidence, and the variants that can be assessed in your data. A DNA result does not directly measure enzyme activity.
The source of these definitions is listed above. Missing variants or incomplete coverage can leave a result indeterminate.
Medications with COMT information
This list contains 3 medications with COMT information from the sources shown below. Evidence and report eligibility differ by drug; each page explains its scope and limitations.
References
- PharmGKB / Stanford University. PharmGKB: The Pharmacogenomics Knowledge Base. pharmgkb.org
Explore COMT in your report
Informational only, not medical advice. The presence of a COMT pharmacogenetic guideline does not mean every patient needs to change their dose. Never start, stop, or change a medication without talking to your prescribing clinician.