Pharmacogenetic Testing

For Mental Health Treatment

Mental health during the COVID-19 pandemic has placed a magnifying glass on those living with mental illness and how it is treated. Millions of Americans live with mental health conditions and those numbers have spiked due to contributing factors surrounding the coronavirus. A poll by the Kaiser Family Foundation (July 2020) concluded that 53 percent of adults in the United States reported that their mental health has been negatively impacted, due to worry and stress directly related to the coronavirus (Clinical Advisor, 2020). Despite this large number and growing awareness surrounding mental health, the stigma and misunderstanding remain widespread.

Depression

Depression is the result of the following contributing factors:

Clinical symptoms present in most depression patients:

Currently, cornerstone therapy for treatment of major depressive disorder is a combination of medication (antidepressants) and therapy (cognitive behavioral therapy and interpersonal psychotherapy). Prescribing antidepressants can be tricky. The majority of antidepressants can take four to six weeks to reach maximum effectiveness, and tolerance and efficacy can make it challenging to relieve patients of symptoms. Therefore, there can be a lot of time involved and trial and error in finding the right medication for a patient.

Pharmacogenetic Testing

Pharmacogenetic testing is trying to take the guesswork out of prescribing antidepressants. Emerging science has looked at testing for genetic variants to assist practitioners in treating patients with depression based on how their body will metabolize the medication.  Although no specific genes have been associated with depression, several genetic variants may help clinicians predict how patients with depression will metabolize antidepressants (Clinical Advisor, 2020).

The process of selecting an antidepressant should take into consideration cost, adverse effects, tolerability, and patient preference. Depending on the patient’s response to the antidepressant the practitioner may need to titrate the dose or change it altogether. This process can take weeks to months and during this trial period, the patient may become frustrated with the process and stop therapy. Stopping therapy is a serious concern because patients with depression that have stopped their medication therapy are at increased risk for suicide or self-harm (Clinical Advisor, 2020).

A management approach that uses pharmacogenetic testing along with clinical judgment has proven to provide superior treatment for depressed patients. Recent research suggests that pharmacogenetic testing improves response and remission rates among individuals with major depressive disorder (Clinical Advisor, 2020).

Conclusion

Pharmacogenetic testing can be done at the Jackson College Health Clinic, and the test is a simple cheek swab. Jackson College sends all pharmacogenetic testing to Myriad Neuroscience in Ann Arbor, Mich. Testing can be processed through insurance, and with traditional Medicare and managed Medicaid the out-of-pocket cost is $0. If you have no insurance, the cost is also $0. With other insurance carriers, the cost is $330 or less.

It is important to note that pharmacogenetic testing is intended to be used by practitioners to assist in medication treatment decision-making. Pharmacogenetic testing offers more information but it does not offer a guarantee that the patient will have symptom resolution. Practitioners need to discuss all options with the patients and apply testing on a case by case basis.

To learn more about this testing visit the GeneSight genetic testing website

References

Clinical Advisor (October 2020). Retrieved on October 21, 2020 from www.ClinicalAdvisor.com

McPhee, S. & Papadakis, M. (2010). Current medical diagnosis and treatment.