Pharmacogenomic testing or PGx testing means understanding the genome and their role in drug response, immune system, mental health disorders, and even how you metabolize substances.
This relatively new addition to western medicine is coming to play an important role in our understanding of how people respond to medication and substances, allowing for personalized treatment based on drug interactions, substance vulnerabilities, and likely responses to medication. This means that it’s also more and more often available for every part of medical health, including mental health treatment.
In short, it means looking at the bigger picture of how your body might handle treatments, allowing your healthcare providers to stop guessing and stop using trial and error and instead switch to something that’s likely to work for you.
Reduce Trial and Error when Receiving Medication
Mental health medications are used as a second line of treatment for many people. That often means you receive therapy such as CBT first in an attempt to give you tools to reduce symptoms. Medications might also be first line, in that you’re handed medication first and therapy second.
However, in each case getting onto medication typically takes 4-8 weeks of starting that medication and dealing with symptoms before finding out if it’s going to work for you. For many of us, we can go through this process multiple times only to find that the medications we are trying have to many negative side-effects or don’t reduce negative symptoms enough. In the meantime, you could be dealing with sleep and appetite problems, low energy, low concentration, upset stomach, headache, and sexual dysfunction. Those symptoms can go away with time, but it can be difficult to try that for 8 weeks only to find out that it doesn’t work. In fact, less than 40% of patients achieve depression remission on their first attempt at taking medication for depression.
Pharmacogenomic testing is a simple mouth swab test that gives doctors a better idea of whether or not you’ll respond to the medication. For example, they’ll look at metabolization and known reactions to the drug to determine if there are known issues or interactions. That means you can start from an informed basis and reduce the chances of trial and error.
Better Understand Dosage and Response Expectations
If your doctor takes the time to look at your metabolism and your known drug interactions, you’ll have a better understanding of which drugs to take and how much of them to take. For example, people with certain genomics will metabolize some drugs very quickly. This means they may not work at all or may work differently than expected. It’s very common for someone with a faster drug metabolism to primarily experience negative side-effects of “going onto the drug” with fewer of the beneficial side effects of uplifted or stabilized mood.
That also holds true with dosage. Normally starting a new mental health drug means starting at the lowest possible dose and then gradually increasing over time until you get somewhere that works for you. This process is long and can be a lot of hassle and can result in a lot of side-effects. If you immediately look at how you metabolize drugs from the start, your doctor can make a better prediction about what dose you need so you can start closer to the target.
Know Which Medications to Avoid
While pharmacogenomics is broader than pharmacogenetics, it can still give you a very good picture of how you’ll respond to medication. As a result, it can help you to red flag certain medications before you have to find out the hard way that you react badly to them. Here, known drug interactions are recorded, meaning that a doctor can see when a medication is probably not a good idea. For example, when Madeline Bohlman took a pharmacogenomic test, her doctor immediately switched her to a different medication because he saw that she had known interactions with her current drug. The result was that she got better results and fewer side effects – all because she took a few minutes to take a cheek swab.
Insights into Why Medications Aren’t Working
The current mental health medication system means taking educated guesses about why medications aren’t reacting as predicted. With pharmacogenomic testing, doctors get more insights into why something is or isn’t working. For example, if your current drug isn’t working, a pharmacogenomic test can point out known interactions and metabolization issues. That means your doctor will have more insight into picking a medication that doesn’t interact in the same ways, so your next drug will be better instead of more of the same.
Pharmacogenomic Testing vs Pharmacogenetic Testing
Pharmacogenomic testing and pharmacogenetic testing sound very similar. Both test the genome and your DNA for potential interactions to medication. However, pharmacogenomic testing tests at a high level. It looks at your genome, how you metabolize drugs, and specific or known interactions. It’s designed to look at variances as a whole to provide fast and affordable looks into what your most likely response to a drug is. The result is you get drug recommendations that provide more effective responses ore an improved benefit profile.
On the other hand, pharmacogenetic testing looks for specific genes that are known to cause issues. It looks for individual genes that have been identified to cause issues. That normally means you should be a high-risk case or your doctor should expect that you have those genes because there are hundreds of thousands of genes that can interact with medication. For example, there are over 600 genes that influence how you metabolize something like alcohol. Looking at these on an individual level can provide very clear and concrete yes/no answers if you’re responding badly to something specifically or you have a history of a gene expression in your family. For example, if you respond badly to SSRIs, it might be because of a gene, and you can test that, giving you medical reasons to switch to another drug.
When to Use Pharmacogenomic Testing
Pharmacogenomic testing can help you improve how you are prescribed and given medication. It means doctors have more insight into what will work for you, in what doses, and why. That’s a great thing for most people. You should especially consider pharmacogenomic testing if:
- You’ve tried medications in the past and they didn’t work well for you
- You might need multiple medications for mental health and physical health reasons
- You’re concerned about potential side effects and want to minimize those as much as possible
- You’re concerned about medication not working
If you’ve decided to ask for pharmacogenomic testing, you can simply talk to your doctor. Or, if you’re going to a mental health clinic, chances are high that you can ask for and receive testing right in the clinic. Of course, you might want to discuss the treatment with your healthcare provider and your insurance provider to make sure it’s covered by your insurance. In some cases, it won’t be, but because pharmacogenomics are usually low cost, it may still be worthwhile to you anyway. Plus, it’s shown to reduce costs for your insurance provider over time, with an average of $2,918 in direct savings in hospital visits, complication treatment, and the cost of switching medication.
If you’d like to know more, talk to your doctor or a pharmacogenomic clinic directly. Alternatively, you can contact us today to learn more and begin your journey to a more personalized treatment plan!