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Genetic Testing Can Assist in Determining the Most Effective Antidepressants

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Many individuals with depression, anxiety or other mood disorders struggle to find effective medications.   It is not uncommon for such individuals to go through many months of frustrating “trial and error” as their prescriber tries to find the right medication and right dosage for their needs.   However, based on a person’s genetic profile, the use of genomic testing is now enabling prescribers to eliminate much of the guesswork in identifying the best combinations of medication.

By testing your DNA for certain gene variations, doctors now have a powerful new tool helping inform the decision of which medications are most likely to be effective, or which may put a patient at risk for side effects.

Out of nearly 25,000 genes in the human genome, eight are known by science to influence the effectiveness of psychiatric medications.  These genes fall into two categories:

1. Pharmacodynamic genes impact how a medication may work on your body, such as the sensitivity level of serotonin receptors in the brain.
2. Pharmacokinetic genes make proteins that affect how quickly drugs are processed by the body, such as the ability of certain enzymes to break down drugs in the liver.

Genetic testing can predict how quickly you will metabolize psychotropic drugs based on your unique pharmacokinetic genes.  For any given drug, your genes may place you into one of four categories relative to your drug metabolism rate:

• Ultra-rapid Metabolizers (UM) process medications extremely fast.  Medications often do not stay in the system long enough to provide symptom relief. UM’s either need higher doses of medication or different medications that their body can absorb more slowly.
• Extensive Metabolizers (EM) have normal rates of absorption and respond well to recommended doses with relatively few side effects.
• Intermediate Metabolizers (IM) have relatively slower rates of drug metabolism and may be more prone to side effects.
• Poor Metabolizers (PM) process medications very slowly, resulting in higher concentrations of medicine in the bloodstream.  FDA dosing guidelines for PM patients recommend lower doses to achieve a therapeutic effect, and caution to monitor for adverse side-effects.

The most common panel of genetic testing for depression is the Cytochrome p450 testing, which is a simple and painless procedure.  A swab is taken of the inside of your mouth and sent to a specialty lab, with results being returned in a matter of days. The use of genomic testing in psychiatry is a relatively new science but is proving to be a valuable tool in augmenting a physician’s decision-making and prescribing.

Pasadena Villa has contracted with Genesight® a Division of Assurex Health to process genomic tests for psychiatric medications including antidepressants and antipsychotics.  The tests can assess the individual’s genetic receptivity of 29 common psychiatric medications.  As a result, prescribers and patients can more quickly identify the medications most likely to achieve symptom relief, in less time, and with a lower chance of unwanted drug side effects.

If you have a friend that needs professional and accredited mental health treatment, please call the Pasadena Villa admissions office at 877-845-5235 or complete our contact form. Our trademarked Social Integration Model strives to teach our clients the independence and social skills needed to live a healthy and productive life after leaving Pasadena Villa. Levels of care offered include intensive residential treatment, community-based residential treatment, day treatment and transitional living. We currently offer treatment at two residential locations in both Orlando, Florida and Knoxville, Tennessee, and outpatient services in Raleigh, North Carolina.

 

References

Serani, D., Genetic Testing for Better Depression Treatment, Psychology Today, July 2014.

Mayo Clinic Overview: Tests and Procedures: Cytochrome P450 tests, August 2015.

Centers for Disease Control and Prevention.  Genetic Testing; CYP450 genotyping to predict response to SSRIs used to treat depression in adults.  July 13, 2015

Horn, Kim, Interpreting the GeneSight Psychotropic Test, Assurex Health, www.genesight.com