Just as our genes determine our eye and hair color, they partially impact our body’s medication response. How genes affect the actions of many drugs used to treat clinical disease is exceptionally complicated, and pharmacogenomics, an entire field of research, is dedicated to this study. The long-term goal is to assist doctors to choose medications and doses best suited for each person, rather than through trial and error and guesswork.
What is genetic testing for medication efficacy?
DNA testing for medication efficacy is based on the belief – and pharmacogenomic studies – that by analyzing specific genes, one can predict which patients might respond well to a drug and which might have severe side-effects. For example, changes within a particular gene lead to differences in the amount of a produced protein, its properties, and its ultimate destination. Such mutations might yield a variant protein that may cause an altered response to a drug.
Genetic studies have led to breakthroughs, such as discovering one of the causes of cell death in Alzheimer’s disease. That said, the genetics of the most prevalent mental disorders is more complicated. Nevertheless, DNA testing for medication efficacy is already a reality with companies selling bespoke tests. While some specialists treating psychiatric patients are still waiting for more comprehensive studies and proof, others are already seeing the benefits of conducting DNA tests and using the results to treat their patients with more precise medication management.
Why the need for change?
Depressive disorders are among the most common conditions that disturb lives. Drugs, psychotherapy, and lifestyle changes have successfully treated depression and related disorders, even if they don’t eliminate symptoms. However, often people don’t gain enough relief from therapy or have to try several medications before finding the one that works. In an era of exciting advances, including brain imaging and genetic testing, many clinicians and patients quite reasonably hope that innovative technologies will provide answers. Several companies are selling genetic tests as a means to guide treatment for antidepressant choices.
In a scientific paper titled “The genetics of mental illness: implications for practice” published in the World Health Organization’s Bulletin, Steven E. Hyman, National Institute of Mental Health Director, gives an in-depth look at the goal of molecular genetic studies of mental disorders. He states that “the concept of a drug target, i.e., a molecular target against which compounds can be tested for inhibitory or facilitative activity, is central to modern processes of drug development. In psychiatry, the identification of effective drug treatments began with a series of serendipitous discoveries, firstly of lithium and later of chlorpromazine, the first antipsychotic drug, and imipramine and the monoamine oxidase inhibitors, the first antidepressant compounds. As was the rule during the 1950s, the actual molecular targets of antipsychotic and antidepressant drugs became known only after the drugs were found to be efficacious.”
In other words, since the 1950s, trial-and-error-based treatment still prevails as the rule of thumb. Hyman writes that “through the integration of information coming from genes, molecules, and cells with that flowing from the environment and experience to the brain’s neuronal circuits, neuroscience can be expected to revolutionize clinical practice.”
According to Jordan Smoller MD, ScD, a U.S. psychiatric geneticist, and Harvard Professor, long before human genome sequencing in 2003, twin and family studies had determined that psychiatric disorders are both genetic and familial. However, detecting the genes involved has been an enormous challenge. Simultaneously, there has been an imperative need to unlock the genetic basis of psychiatric illnesses. However, while psychotropic drugs help many and can be life-saving, “there is a striking fact about available drug therapies: they are all based on serendipitous discoveries and biological insights that date to the 1950s and 1960s. When it comes to treating psychiatric disorders, we are still living in the ‘Mad Men’ era.”
It is time for modern scientific ways to change patient outcomes. It is also only a matter of time before it becomes mainstream to use gene analysis to provide faster relief and better results. Bottom line, change is not only essential but inevitable.
How do I check my DNA?
OmeCare offers Omecare PsychiatricMeds and Pain Tests. These are pharmacogenomic tests that analyze how your genes may affect the efficacy of medications. The tests examine clinically significant genetic variations in your DNA through a simple cheek swab that you do from the comfort of your home. The results can inform your doctor about how your body may break down or respond to certain medications commonly prescribed to treat depression and pain issues. By narrowing down medication options, patients are more likely to avoid suffering the side effects of medicines that don’t work and achieve positive outcomes quicker.