Polymorphisms in the IL1-b gene are associated with increased Glu and Glx levels in treatment-resistant depression

•Metabolic alterations in the ventromedial prefrontal region were examined in depressed patients employing imaging genetics•Polymorphisms in inflammatory genes might be associated with increased Glutamate and Glx levels in difficult to treat depressed patients•Increase in treatment resistance score might be associated with changes in metabolites’ levels•There is an interaction between genotype and resistance score manifesting in elevated glutamatergic metabolic levels in treatment resistant patients