If you or a family member have sought care from a mental health professional, or are considering seeking help for depression, anxiety, ADHD or other conditions, you want the best treatment available. Multiple treatment options now exist for many of these conditions, ranging from medications and psychotherapy to alternative treatments. It can be confusing to sort through your choices and determine what approach will give you or your loved one the ideal outcome.
Psychiatric medication is often prescribed on a trial-and-error basis, with practitioners monitoring each patient’s response before adjusting medications or doses. This process often led to patient frustration, along with added healthcare costs and potentially making their condition worse before finding the optimal treatment. In fact, 50% of depression patients do not respond to the first medication.1
In recent years, the understanding of the role genetics plays in mental health has grown exponentially. With that understanding has come the ability for genetic testing to provide answers to questions patients and their healthcare providers have about personalized treatment options.
An individual’s mental health and wellness is a function of genetics, lifestyle, environment, and experiences—this is called the Mental Health 360. Until now, we’ve been missing an important piece of the puzzle when it comes to mental health drug response: genetics. With this information, healthcare providers can obtain a more complete picture of their patient to identify a personalized treatment plan.
Pharmacogenetics: implementing personalized medicine
Your genetic makeup, also known as your genotype, is your inherited DNA code, which serves as the building blocks of you. We get two copies of most genes – one copy is inherited from each parent.
Our DNA is 99.9% the same from one person to another—and it’s that 0.1% difference or variation that makes us unique individuals. It’s this tiny but important piece of your unique genetic makeup where genetic testing focuses.
Just as genetic testing has opened a window on greater understanding of our ancestry, physical health and predispositions to certain illnesses, today’s sophisticated genetics can help healthcare providers make more personalized medication choices.
This breakthrough science, optimized for mental health by Genomind® over the last decade, is called pharmacogenetics. Pharmacogenetics testing provides clinicians with a clearer picture of an individual’s response to medications such as understanding potential likelihood of efficacy or side effects and understanding how the body metabolizes medication to guide dosing decisions.
How does pharmacogenetic (PGx) testing work?
- Pharmacokinetic effects: Certain genetic enzymes control how quickly your body breaks down medications. If your body metabolizes a drug quickly, you might not receive the benefits, or you may need a higher dose. If your body metabolizes a drug slowly, you might experience side effects or possible toxicity. If you are a slow metabolizer, you may need a lower dose, or in some cases, may need to consider avoiding that drug altogether. Genomind’s PGx test analyzes 9 of these genes.
- Pharmacodynamic effects: Certain genetic mutations can be used to help predict the effect a particular drug will have on your body. Genomind’s PGx test analyzes 15 pharmacodynamic genes that can be used to influence drug choice after reviewing your symptoms, past treatment responses, your family history of treatment response and your individual treatment goals.
Genomind’s pharmacogenetic testing collects a DNA sample from a painless cheek swab. Then, certified lab technicians and state-of-the-art technology work together to test specific genes. It’s this information, coupled with a complete patient history, that healthcare providers use to tailor treatment to the individual.
Who is pharmacogenetic testing most useful for?
Pharmacogenetics can be particularly beneficial for patients with depression or mood disorders that are resistant to pharmaceutical treatments. It can help healthcare providers understand their response to different drugs. If a patient doesn’t respond as desired to a medication, or they experience an adverse reaction, understanding their genetic make-up could guide more personalized prescribing decisions.
Population health tools, such as Genomind’s, can also help clinicians identify ideal candidates for PGx testing by stratifying patient populations based on their medication and genetic interaction risk. (Learn more about this with our risk stratification definition.)
Applications of pharmacogenetics
Award-winning psychiatrist and author Dr. Bruce Kehr has been using genetic testing to evaluate patients in his practice at Potomac Psychiatry. “Using critical information from a patient’s genetic makeup, in combination with their current health condition and their health and family history, we have a much more complete picture, allowing us to personalize treatment options for each individual,” said Kehr, “And this can improve the odds of the best possible health outcome for each person.”
Jennifer C, mother of a Genomind patient, shared, “I watched my daughter struggle for years and we had many moments of despair as she spiraled into the depths of anxiety and depression. We wondered if we’d ever find treatments for her that would work. Using Genomind’s test has been a lifesaving part of my daughter’s treatment.”
Sarah B, a previous Genomind patient stated, “I have suffered from severe anxiety/depression for my entire life. It was annoying and difficult going through so many medications just to find one that “might” work for me. My psychiatrist suggested getting this report to see what medicines would work well with my specific genes. I am 22 year old and the information I was given will be relevant to me for the rest of my life.”
Board-certified psychiatrist Dr. Scott Wiener uses Genomind testing to help make decisions about patient care. “Not everyone reacts to the same medication the same way. It’s important to know what the likely outcome may be for each patient before prescribing medications,” said Wiener. “Pharmacogenetics is a valuable tool to help make better informed decisions for patients.”
Designed to reduce the pain of treatment by trial and error
Using Genomind’s leading pharmacogenetic test, healthcare providers can use the patient’s genetic information to narrow down which types of medications may be more effective, more tolerable and what starting doses may be best.
- Trivedi MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28-40.