Personalization. Every company wants to create unique experiences for its customers. For most industries, that requires digital data and user experience designers. For the medical community, it means considering health factors such as a person’s genetics.
Your genetic makeup, or genotype, is your inherited DNA code. It serves as the building blocks of your body. Your genetics, along with an assessment of your current health and family history, compose the trifecta of information that clinicians now use to drive individualized treatment decisions. This shift from a one-size-fits-all approach to a patient-centric strategy is also known as precision health.
Clinical genetic testing has long been used to determine health risk. A familiar example may be prenatal genetic testing. During prenatal genetic testing, various blood screenings and other diagnostic tests are used to determine whether your baby will be born with a chromosomal abnormality, such as Down syndrome; or an inherited disorder, such as sickle cell disease.1
Clinicians also use genetic testing when prescribing – meaning they assess your specific genes to determine how you’re likely to respond to specific medications. This type of testing has been used to tailor drug treatments for certain cancers,2 cardiovascular disease, HIV/AIDS,3 and other medical conditions. For example, research has shown that genetic testing for mental health medications can be particularly beneficial for those with treatment-resistant depression (see: “Genetic testing for depression medication” for more).
Genetic testing for mental health medications
Not everyone reacts to medications in the same way. You may start feeling frustrated if you don’t receive any benefit from your first trial of medications for your depression or anxiety, or if your symptoms worsen.
Unfortunately, this experience is common during mental health treatment. Studies have demonstrated that two-thirds of individuals with depression do not achieve complete relief from their first medication.4 It is also estimated that 31% to 48% of children treated with antidepressants will not respond to their prescribed medication.5
Your genetic makeup can affect your response to certain drugs. It can also influence whether you will experience negative side effects or adverse drug reactions. Using genetic testing for mental health medications, clinicians can narrow down which drugs may be more or less likely to work for you, and at which dose. This may reduce the trial and error that often happens with usual treatment.
How it works
The science behind genetic testing for medication response is known as pharmacogenetics (you may also see it written as pharmacogenomics, or PGx). Pharmacogenetics combines the science of pharmacology (how drugs work) and the science of genomics (the study of the human genome).
For example, the Genomind Pharmacogenetic Test looks at the key genes that may influence your clinician’s medication selection and dosage decisions for ADHD, depression and other mental health conditions. It identifies your unique genetic markers that can indicate which treatments may be more likely to work as intended or cause adverse effects.
Genomind’s pharmacogenetic testing focuses on two primary mechanisms to help clinicians determine medication treatment: pharmacokinetic effects and pharmacodynamic effects.
Pharmacokinetic Effects
Certain enzymes control how quickly your body, specifically your liver, breaks down the medications you take:
- If your body metabolizes a drug quickly, you might not receive any benefits, or you may need a higher dose.
- If your body metabolizes a drug slowly, you might experience side effects or possible toxicity. You may need a lower dose or may consider avoiding that drug.
Understanding this metabolic effect is the main reason Jay Fawver, MD, a psychiatrist at Parkview Health in Fort Wayne, Indiana, recommends genetic testing to his patients. “Genomind analyzes six genes that code for enzymes that break down 90 percent of all medications,” he says. “By having an awareness of how people break down 90 percent of their medications, we can dose our medications accordingly.”
Pharmacodynamic Effects
Certain genetic mutations can be used to help predict the effect a particular drug will have on your body. Understanding your genetic makeup on these key areas offers your clinician personalized insights for their prescribing.
Supporting evidence
“When medication registrations are done for FDA approval, those studies give us information for the average patient, such as how well a particular dose works on average in terms of side effects and efficacy,” says Roy Perlis, MD, MSc, a professor of psychiatry at Harvard Medical School and a Genomind Scientific Advisory Board member. “What genetic testing can help determine is how someone’s ability to metabolize a particular drug relates to that average.”
As new research becomes available, the Food and Drug Administration (FDA) continues to add genetic biomarker labeling information, such as warnings and genotype-specific dosing, for numerous drugs. Today, over 300 drugs contain FDA warnings, precautions, dosage recommendations or drug-drug interaction guidance based on specific gene variants. That list includes dozens of drugs commonly used in psychiatry, such as certain antidepressants and antipsychotics.6
How to get genetic testing for mental health medications
Any doctor or pharmacist can recommend that you receive genetic testing for mental health medications, but only a licensed prescriber can order it for you. The testing can be simple and painless. For example Genomind’s PGx test requires just a cheek swab sample, which can be collected at home or at your clinician’s office.
Once Genomind’s lab receives your sample, you and your clinician will receive your results within three to five business days. You can authorize other clinicians to receive your results as well.
Pharmacists and other experts can also help guide your clinicians with medication decisions through Genomind’s Precision Medicine Consults – included with every test. This can be helpful, “especially those who may not be familiar with the research and language of pharmacogenetics,” says Melissa Frontino, PharmD, a clinical pharmacist.
“Your specific genes don’t change over time. While the test will evolve and may expand the genes it tests, the results you get from this test will continue to aid your health decisions for years to come,” says Frontino.
Does Your Medication Work for You?
Get a lifetime of mental health treatment guidance. Genomind’s leading pharmacogenetic test was designed to help your clinician personalize your treatment plan based on your genetic profile. Get started today.
Sources:
- Background on prenatal genetic testing: Prenatal Genetic Testing (2022)
- Genetic testing for medications for cancer treatment: Pharmacogenetics of cancer therapy: breakthroughs from beyond? (2015)
- Genetic testing for medications for HIV treatment: Emerging role for pharmacogenomics in HIV research in Africa (2021)
- Two-thirds depression patients do not achieve relief: Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice (2006)
- 31-48% children do not respond to antidepressant: Antidepressant pharmacogenetics in children and young adults: A systematic review (2019)
- FDA drugs with genetic-specific warnings: Table of Pharmacogenomic Biomarkers in Drug Labeling (2022)
