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Explained: What Is Pharmacogenetics for Mental Health Treatment?

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 assessing your specific genes to determine how you’re likely to respond to specific medications. This is known as pharmacogenetics (PGx).

This shift from a one-size-fits-all approach to a patient-centric strategy is also known as pharmacogenomics, combining the science of pharmacology (how drugs work) and the science of genomics (the study of the human genome).

Your genetic makeup, or genotype, is your inherited DNA code. It serves as the building blocks of your body. These personal genomics, 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 is at the heart of precision or personalized medicine.

Understanding Pharmacogenetics

Clinical genetic testing has long been used to determine health risk. The most familiar example is 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 neural tube or other birth defect, such as spina bifida; a chromosomal abnormality, such as Down syndrome; or an inherited disorder, such as sickle cell disease.

Even though pharmacogenetics was first established in the 1950s, only recently has it begun to be used to tailor drug treatments for certain cancers, cardiovascular disease, HIV/AIDS, and other medical conditions.

In addition, research has also shown that pharmacogenetics can be beneficial to those with mental health conditions, particularly those with treatment-resistant depression or mood disorders.

Pharmacogenetic information is also being used to develop new drugs aimed at patients with specific genetic profiles. As new research becomes available, the Food and Drug Administration (FDA) continues to add pharmacogenomic biomarker labeling information, such as warnings and genotype-specific dosing, for numerous drugs.

Dozens of drugs commonly used in psychiatry, such as certain antidepressants and antipsychotics, include pharmacogenomic biomarker data in their product information. These genetic associations include warnings, precautions, and dosage recommendations.

The Effect of Pharmacogenetics on Your Health

Not everyone reacts to medications in the same way. You may start feeling frustrated if you don’t receive any benefit from the first-line treatments for your mood disorder, or if your symptoms worsen.

Unfortunately, this experience is common during mental health treatment. Up to half of all patients do not respond as desired or may even experience adverse reactions to the first psychiatric medication they’re prescribed, according to a study in Current Psychiatry Reports. This is partly due to their genetic makeup.

“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 the genetic testing can help determine is how someone’s ability to metabolize a particular drug relates to that average.”

Your genotype can affect your response to certain drugs. It can also influence whether you will experience negative side effects or adverse drug reactions. Using pharmacogenetics, clinicians can narrow down which medications may be more or less likely to work better for you, and at which dose. This may reduce the trial and error that often happens with usual treatment.

What Does Pharmacogenetics Involve?

The pharmacogenetic test process for mental health treatment is simple and painless. Using a cheek swab, the Genomind® Professional PGx Express™ looks at the key genes that may influence your clinician’s treatment choice and medication dosage for depression and other mental health conditions. It identifies your unique genetic markers that can indicate which treatments are more likely to work as intended, have no effect, or cause adverse effects.

To help clinicians determine medication treatment, Genomind’s pharmacogenetic test analyzes 24 genes. Genomind Professional PGx Express focuses on two primary mechanisms: pharmacokinetic effects and pharmacodynamic effects.

Pharmacokinetic Effects

Certain genetic 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. Genomind Professional PGx Express analyzes 24 pharmacodynamic genes that can be used to influence drug choice after reviewing your symptoms, past treatment responses, family history of treatment response, and your individual treatment goals.

Pharmacogenetic testing can’t yet independently determine which specific medication you should take or how well other medications will work for you, but it offers personalized guidance to your clinician.

How You Can Get the Genomind Test

Any doctor or pharmacist can recommend that you receive pharmacogenetic testing, but only a licensed prescriber can order Genomind Professional PGx Express. You can have the cheek swab done at participating Genomind providers.

The ordering clinician will receive an online patient report within three to five days of receiving your sample at the lab. You can authorize other clinicians to receive your results as well.

You can also have Genomind Professional PGx Express testing done at select Acme, Albertsons, Jewel-Osco, and Sav-On pharmacies nationwide. Trained pharmacists at these locations will review your results with you and answer any questions.

Pharmacists can also help guide your clinicians with medication decisions, 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. “The gene sequence tested tells us more information about how your body will process particular drugs. It gives us more specific parameters around what your body is doing to the drug or what a drug is doing to your body.”

Does Your Medication Work for You?

Get a lifetime of smarter mental health treatment guidance. Genomind’s leading pharmacogenetic test was designed to help your clinician personalize your treatment plan based on your genetic profile.

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