Does Genetic Testing For Antidepressants Work
One of the most common questions people ask is if genetic testing for antidepressants works. Many studies have shown the findings from genetic testing have successfully treated depression. Harvard Medical School is still skeptical, but the Food and Drug Administration is not discounting it as a possibility. In 2020, the FDA reviewed scientific evidence and issued a table of gene-drug interactions for which genetic testing is appropriate to determine safe medications and doses.
Pharmacogenomic tests are the future, and as more people use them, they will grow in popularity. A patients response to the medications and dosages prescribed based on the test report is what shows how well it works.
Can Genetic Testing Help Determine The Best Medications For You
- By Shannon Manzi, PharmD, Contributor
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The saying if it seems too good to be true, it likely is applies to so many things in life. As the director of the Clinical Pharmacogenomics Service at Boston Childrens Hospital, I spend a significant amount of time discussing what pharmacogenomics testing cannot tell us. I am sure you are wondering why I would take a negative approach instead of touting the miracles of pharmacogenomics testing, since after all, that is my job. Well, as with many things, it is complicated.
How To Talk To Your Doctor About Finding The Right Medication
Talk to your doctor about whether genetic testing could be useful for helping you find the right medication. Patients who are in crisis, have treatment-resistant depression or another condition that isnt responding to medication are sometimes more likely to be recommended for genetic testing.
Your primary care doctor may refer you to a psychiatrist for more specialized medication knowledge or another clinician who can evaluate whether genetic testing could be beneficial.
In advance of your appointment, prepare notes about the following information:
- Medications youre currently taking
- Medications taken in the past and any side effects
- Family history of mental illness and responsiveness to medications
- Symptoms currently experienced
- Diet and nutrition information including recent weight loss or weight gain
- History of tobacco, alcohol, and drug use
Genetic testing isnt a magic solution to a persons mental health challenges, but it can sometimes provide your doctor with important information about how your body will metabolize certain medications. Many people, however, find the right medication for their symptoms without the use of genetic testing. So dont be discouraged if it is not an option or not covered by your insurance.
Genetic Testing For Mental Health Medications For Depression Anxiety
I would be very interested to hear from anybody who has had genetic testing to help determine which meds may or may not help withdepression and anxiety and whether it has made a difference in their health.Many thanks
Hello, we’ve had members talk about this topic, and I’d love for you to meet some of them. Please meet , a volunteer mentor here on Connect who has some experience with genetic testing related to drug metabolism. and , also volunteer mentors, may have some thoughts on testing in this arena. has also talked about this and may have some thoughts for you.
are you considering doing genetic testing to find an appropriate medication for depression and anxiety?
, I have a new psychiatrist and she intends to do a cheek swab on my next visit. The med she started me on just hoping to give me some relief from the twists and turns of my last two may not be the right one for me as we discovered after taking it for a week, but it may just be a little early to know. She also said that it would help with titration of dosage because she will learn some things about my metabolic rate and not only with what she prescribes but also the pain medications I take. I will report back when I have some results, but I expect that to be a few weeks. Peace to you both, Gary
are you considering doing genetic testing to find an appropriate medication for depression and anxiety?
Working With Your Provider
One way to make sure that you get the most out of your anxiety treatment plan is to establish a good relationship with the provider managing your mental health care. Dont be afraid to speak up if youre struggling with medication side effects or need clarification regarding psychiatric diagnosis or other therapeutic interventions. After appointments, check in with yourself and ask whether you feel understood and supported regarding your mental health. If yes, then youre on the right track to improving your mental health.
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Does Insurance Cover Genetic Testing
Some health insurance plans do cover genetic testing. However, it depends on the plan and the patients history. Some insurers also demand additional documentation proving that the test is necessary. A doctor must provide this documentation.
Certain genetic testing companies do offer payment assistance to patients whose insurance does not cover genetic testing.
What Do Experts Say About Using Gene Tests To Determine Treatment For Depression
Against this background, experts with no financial interest in genetic testing have repeatedly recommended that genetic tests should not be used in choosing treatments for depression . The American Psychiatric Association convened a task force that reviewed the evidence and agreed: the tests should not be ordered.
Recently, the FDA advised that the tests had no proven value and should not be used. Then they went two steps further, stating that use of the tests could lead to inappropriate treatment choices that might harm patients. Additionally, the FDA sent a warning letter to one company and has contacted others selling the tests, advising them that they cannot legally make specific recommendations to clinicians or patients based on their test results.
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How Does Genetic Testing Work
Genetic testing is designed to be easy and painless. To complete the test, a laboratory collects a small sample of blood or saliva from the patient. The sample is usually sent to a pharmacogenomic testing laboratory to be analyzed. This lab sequences the DNA and analyzes any variations or changes in specific genes that are associated with how you respond to a particular medication. Testing for a specific kind of medication only has to be done once, but you may require additional pharmacogenomic testing if your doctor wants to evaluate you for another type of medication.
The Financial Benefits Of Genetic Testing
In his research using health claims data, Dr. Perlis and his Stanford colleague Guido Imbens found that patients who received genetic testing prior to treatment for mood disorders had lower healthcare-related costs, compared to those who didnt receive the testing.
Over a six-month period, those who received genetic testing had, on average, 40% fewer all-cause emergency room visits and 58% fewer all-cause hospitalizations. Healthcare costs for the tested group were estimated to be $1,948 lower.
From the beginning, we expected to see savings beyond psychiatry, says Dr. Perlis. The study showed that the test had enough of a reduction in cost to be cost-effective.
Some of this could be attributed to better outcomes for diseases that can be exacerbated by depression, as it can often travel with conditions such as diabetes, cancer, and heart disease.
Its repeatedly been shown that depression makes everything else more expensive and harder to treat, says Dr. Perlis. Apart from the fact that we should manage depression for its own sake, we also need to be more efficient in how we manage depression because of all the potential follow-on benefits for the rest of someones health.
As for the concern that genetic testing could lead to using more expensive medications? We havent seen evidence of that. In our study, medication costs were not any greater in people who got the test, says Perlis.
Most patients with commercial insurance will pay $325 or less.
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How Is Genetic Testing Done
Genetic testing is a quick and straightforward process, though the time it takes to receive results can vary. Some genetic testing forms only involve inserting a cotton swab inside your cheek and collecting DNA via your saliva. This form of genetic testing can yield results in around five days. Another form of genetic testing involves a blood test. For prenatal testing, a cotton swab is used to collect DNA from the uterus and abdominal wall.
Testing can be done at a doctorâs office or specialist treatment center. When looking for a doctorâs office that does genetic testing, be sure to ask if they do genetic testing for mental illnesses before making an appointment. Tests taken from a patient will be sent to a laboratory, where results will be determined. The time in which you receive results can vary, but your doctor will likely be able to give you a time frame.
Drug ‘trial And Error’ Until Now
The testing Ms Black took to narrow down her search for the right medication which involved a brain scan and a cheek swab is not widely used in mainstream healthcare.
The collected cells are used in a multi-gene test, otherwise known as a pharmacogenomic test, which surveys around one dozen genes that are known to play a role in metabolism.
The same test will be applied to hundreds of newly-diagnosed patients in WA, NSW and Victoria as part of a study to determine whether first-line medications have a better chance of succeeding if their prescription is guided by the patient’s individual genetic make-up.
WA North Metropolitan Health Service psychiatrist Sean Hood said finding the right medication for depressed patients often involved trial and error.
“Most patients, when they get treated depressive disorders, don’t get full remission on the first medication they are put on,” he said.
“Trialling and looking at different medication therapies can take a lifetime for many patients it can take many years.
“In the past, it has just been clinical wisdom and therapeutic guessing to find the medicine that is going to be best for that person.
“But this sort of testing hopefully will give us the ability to better target the medications that are going to be suitable for that patient early on.
“I hope this can be a game-changer for the treatment of mainstream depression.”
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Do I Need An Anxiety Gene Test
While theres no harm in having your genes tested, some individuals may benefit from testing more than others. You should consider getting tested if any of the following applies to you:
- You notice anxiety symptoms: If you experience intense panic or chronic fear, you might want to check to see if you are predisposed to anxiety.
- You have a family history of anxiety: Having relatives with anxiety disorders increases your likelihood of developing one.
- You have an underlying medical condition: If you have a health condition in addition to anxiety, youll want to ensure that your anxiety medication does not interfere with the condition.
- You have a family history of adverse effects: If you or your relatives have a history of reacting negatively to medications, you should consider gene testing.
Ultimately, anxiety gene testing can benefit anyone who is looking to confirm a diagnosis or is trying to find a suitable medication.
How Do Pgx Test Results Affect My Prescription
PGx tests tell your medical provider how your genes differ from othersand how these differences affect your metabolism. Your PGx test tells you what version of each gene you have. It then provides a list of medications that will work best with the enzyme encoded by that gene. This list might also come with some recommendations.
For example, having a certain genetic variation might result in you having a slow metabolizer enzyme variant. Because this type of enzyme breaks down medication more slowly than average, a certain drug may stay in your system longer than usual. This can lead to negative side effects. A PGx test might recommend that your provider not prescribe this medicationor at least lower the dosage to prevent side effects. Without a PGx test, you would only find this out by trial and error.
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How Dna Testing Can Help People With Depression
Not everyone reacts to medications in the same way, and finding the right medication to treat depression may take some trial and error. In fact, up to half of all patients do not respond as desired to the first psychiatric medication they are prescribed. This is due in part to their individual genetic makeup .
In very recent years, however, scientists have identified innovative ways to use genetic testing to help personalize medicine, so it better meets the needs of individual patientsand can help healthcare providers make informed treatment decisions for patients who have depression.
The information revealed by a patients DNA can also help a doctor better understand if a patient might experience negative side effects or adverse drug reactions, and avoid those options.
Depression. Anxiety and Depression Association of America, ADAA, Anxiety and Depression Association of America, .
With good information, you can better understand how these conditions may affect you, your loved one or your patient. The better informed you are, the better you can advocate. Learn more by clicking the topics below:
What The Fda Says About Genetic Testing For Antidepressant Medications
The Food and Drug Administration has started to consider pharmacogenetic testing as a viable approach to identifying the best drug therapy for those suffering from mental illness. This is not a surprise as geneticists and researchers have found that DNA variations among groups of people with similar mental health concerns and treatments are similar.
As more research is performed and more people follow the recommendations by their gene test, many organizations including the American Psychiatric Association will begin to support the use of pharmacogenomics in psychiatry.
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The History Of Genetic Testing
In the 1950s genetic testing was first used as a way to spot the signs of Downs syndrome early on. This started when scientists discovered that the extra copy of chromosome 21 in someones DNA was responsible for Downs syndrome. Shortly after DNA was used in police work. in 1984 Alec Jeffreys established a way to spot unique patterns in what was commonly known as junk DNA because scientists didnt know what its purpose was. These patterns can be used to definitively identify people in a way never possible before. It has even been used to exonerate innocent people.
In addition to assisting in both the medical and police industries, genetic testing has many other uses. Quite a few companies have sprung up that use this new science to help people find their ancestry. Paternity tests are also fairly common and easy to get because of genetic testing.
Another niche field that has recently been opened up by genetic testing is pharmacogenetics. This is the study of how your specific genes can potentially impact your bodys response to medications. Because of this field, it is now possible to receive genetic testing for depression meds.
The Need For Genetic Testing For Antidepressants
For many years, people suffering from depression, bipolar disorder, anxiety, and many other mental health conditions simply had to take their chances when taking medications. Mant lives have been lost because they took their own lives due to a side of their medication or they didnt take their antidepressants and their condition led them to suicide. Either case is devastating and thats why genetic testing is such a huge light in the darkness of treating depression.
With the genetic information that can come from analyzing a persons raw DNA data, individuals can increase their chances of finding the right medication and dose for them.
If youre suffering from depression or another mental health condition, consider genetic testing. It could provide you with the information needed to finally find a drug treatment that will work for you.
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An Experimental Genetic Test Gives Early Warning For Kids At Risk Of Type 1 Diabetes
This skepticism is shared by some insurance companies. “Anthem considers these tests investigational and not medically necessary,” says a spokesman for the carrier, which covers 41 million people. The Blue Cross Blue Shield Federal Employee Program, which covers about two-thirds of government workers and their families, said “there is not enough evidence at this time to determine the effect of genetic testing on health outcomes,” according to a spokeswoman.
Test makers are also facing FDA objections that they haven’t proven some of the claims underpinning genetic tests for medications, including that antidepressants work better with some gene variants.
“Changing drug treatment based on the results from such a genetic test could lead to inappropriate treatment decisions and potentially serious health consequences for the patient,” the agency warned in late 2018. It told companies to stop naming specific drugs, in marketing materials or test results, for which its tests “claim to predict a patient’s response” without “scientific or clinical evidence to support this use.”
Most test makers complied. One, Inova Genomics Laboratory, stopped selling a range of tests, including its test for mental health disorders, after the FDA followed up with a warning letter in April.
Benefits Of Gene Testing For Antidepressant Response
Pharmacogenetic testing has many benefits:
- Test results reveal the best types of medications for a person.
- Health care providers can use pharmacogenetic tests to choose psychiatric medication dosing.
- People who use pharmacogenomics testing experience the effectiveness of antidepressant medications much sooner.
In the following video, watch someone who used pharmacogenomics testing for antidepressants.
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