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    Can Genetic Testing for Medication Response Transform Mental Health Treatment?

    February 5, 2021
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    Your phone recognizes you by your fingerprint or face. When you scroll through social media, you’ll find suggested posts tailored to your interests. Need a new pair of jeans? You’ll have a choice of sizes, lengths, and styles—because everyone’s body is a little different.

    Personalization is everywhere in our daily lives. Wouldn’t it be great if treatment for anxiety, depression, or attention deficit hyperactivity disorder (ADHD), for example, could also be tailored to you?

    Now it can, thanks to pharmacogenetic (PGx) testing for mental health medication. With PGx testing, your clinician can gain a better understanding of how your unique genetic makeup influences how your body may respond to certain mental health medications.

    This insight can help your clinician consider which medications might do a better job of relieving your symptoms—and which medications to avoid because of a higher risk of side effects.

    “And knowing how a patient metabolizes drugs means a more personalized and informed approach to treatment,” says Jay Fawver, MD, a psychiatrist at Parkview Health in Fort Wayne, Indiana.

    The Genomind® Professional PGx Express™ test, which is available by prescription, looks at 24 genes related to mental health treatment. It provides guidance across 10+ mental health conditions and 130+ medications to help clinicians determine:

    • Which medications will likely be the most effective
    • Which medications may have side effects
    • How you metabolize medications for personalized dosing guidance

    Here’s a closer look at how PGx testing can transform—and tailor—treatment for mental health conditions.

    Condition #1: Anxiety

    Anxiety is the most common mental health condition among Americans, and it can affect both adults and kids. About 19 percent of adults and 7 percent of children and teens have an anxiety disorder, according to the latest data.

    For some people, talk therapy or lifestyle changes like exercise may be enough to control anxiety symptoms. But many others may need medication to find relief.

    Selective serotonin reuptake inhibitors (SSRIs) are a common medication for anxiety. They work by preventing the reuptake, or reabsorption, of serotonin in the brain—which increases serotonin levels and helps improve mood.

    SSRIs include:

    • Citalopram (Celexa)
    • Escitalopram (Lexapro)
    • Fluoxetine (Prozac)
    • Fluvoxamine (Luvox)
    • Paroxetine (Paxil)
    • Sertraline (Zoloft)

    But if you have a variant of the SLC6A4 gene, your clinician may be prompted to consider a different medication. “If you have certain variants, SSRIs are less likely to work well for you—and more likely to cause adverse reactions,” says Greg Cooper, APRN-BC, a psychiatric nurse practitioner at Delaware Behavioral Health.

    Learn more about genes that can affect anxiety and depression treatment. Plus, if your child has anxiety, check out what you should know about SSRIs and SNRIs.

    Condition #2: Depression

    If you have taken medication for depression, there is a good chance that a first attempt didn’t relieve your symptoms as much as you or your clinician would have liked. In fact, two out of three patients with depression don’t achieve complete relief following their first medication, according to a study in the American Journal of Psychiatry.

    Sometimes, even a second attempt at medication doesn’t bring the desired results.

    It can be tempting to give up on treatment, but it is important not to. Untreated depression can hamper quality of life and increase your risk for suicide.

    PGx testing can be especially helpful for patients with depression who have had difficulty finding the right medication. “Once a patient has failed two courses of medication, testing merits thoughtful consideration,” says Scott Aaronson, MD, director of clinical research programs at Sheppard Pratt Health System and a Genomind Scientific Advisory Board member.

    Some clinicians may also recommend PGx testing at the start of treatment to help minimize trial and error. The sooner you can find a treatment that works for you, the sooner you can start to feel better.

    One more thing to keep in mind: Depression often requires long-term treatment. Follow these steps to cope with chronic or recurrent depression.

    Condition #3: Attention Deficit Hyperactivity Disorder (ADHD)

    People with ADHD have a hard time maintaining focus or sitting still. For adults, this can make work and relationships challenging. For kids, this can lead to difficulties in school and at home.

    ADHD in kids can be particularly tricky for a number of reasons. It can be hard to tell the difference between normal childhood behavior and ADHD. Plus, children with ADHD often have another mental health condition, such as anxiety or depression, or a related issue, such as a learning disorder.

    Even after a proper diagnosis, starting or adjusting treatment requires careful consideration. Your child’s clinician will need to determine:

    • Which medication to try
    • Which dosage to try
    • Any adjustments to accommodate multiple mental health conditions or medications

    This is where PGx can be especially helpful for ADHD treatment. The COMT gene, for example, can help a clinician make a more informed decision about which medication to try, says Amy Edgar, APRN, a nurse practitioner and founder of the Children’s Integrated Center for Success in Allentown, Pennsylvania. Plus, the CYP450 genes, often called metabolism genes, can help with dosage.

    Learn more about how PGx testing can personalize ADHD treatment.

    Condition #4: Schizophrenia

    Schizophrenia is a condition that results in unusual thoughts and behaviors, and it can cause significant disability. People with the condition may experience psychotic symptoms, such as believing things that are not based in reality (delusions) or seeing or hearing things that don’t exist (hallucinations). They may lose touch with reality and have a higher risk of suicide than the average person.

    Simply put, schizophrenia is a complex mental health condition—but it’s treatable. Fortunately, antipsychotic medication can help relieve delusions and hallucinations.

    For treatment to work, it’s critical for a patient to follow a medication plan exactly as prescribed. A clinician can help by taking steps to minimize side effects, such as drowsiness, dry mouth, upset stomach, or constipation.

    “Each antipsychotic has a different side effect profile that has to be taken into account—and tailored for each person individually,” says Anil Malhotra, MD, director of psychiatry research at Zucker Hillside Hospital in Glen Oaks, New York, and a Genomind Scientific Advisory Board member.

    For schizophrenia, PGx testing can provide insights on genes that may affect treatment with antipsychotics:

    • COMT
    • MC4R
    • 5HT2C
    • DRD2
    • ABCB1

    Living with or caring for someone with schizophrenia? Check out how PGx testing can help schizophrenia treatment.

    Condition #5: Post-Traumatic Stress Disorder (PTSD)

    Here’s a surprising fact: About 7 to 8 percent of people who experience trauma develop PTSD, according to the National Center for PTSD.

    Here’s another surprising fact: Even though PTSD treatment is available and effective, most people with PTSD don’t get treatment. Untreated PTSD means you may continue to have symptoms, such as flashbacks, bad dreams, intrusive thoughts, or re-experiencing a trauma.

    So, why do people miss out on treatment? One possible reason is that they may have misconceptions about trauma and PTSD.

    “Trauma can come in many forms—it can be any event, circumstance, or set of circumstances that are physically or emotionally harmful and have lasting adverse effects on a person’s functioning or sense of well-being,” says Arianna Galligher, a licensed social worker and associate director of the Trauma Recovery Center at Ohio State University Wexner Medical Center.

    For men, trauma is typically an accident, physical assault, or military experience. For women, it’s more likely to be sexual assault or child sexual abuse.

    Another misconception is that there’s nothing you can do about PTSD. But the truth is cognitive behavioral therapy (CBT) and mental health medication can help. And if your clinician recommends medication, PGx testing can help tailor your treatment plan.

    Have you had a traumatic event? If it’s been months or even years after the fact and you are having a hard time coping, consider if you might be at risk for PTSD. If the answer is “yes,” make an appointment with a clinician.

    If you are a veteran, PTSD treatment and the Genomind PGx test are available through the VA. Find your local VA here

    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.

    GET STARTED TODAY

    Topics: pharmacogenetics

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