Many patients in the past have experienced discouraging results after trying medications for depression, anxiety, bipolar disorder, ADHD or other problems. Sometimes the medicines cause side effects that are intolerable, simply don’t work, or even made symptoms worse.
In recent years it’s been discovered that the reason medications work differently for different patients can be linked to the way your body processes the medications. Different ways of metabolizing different chemicals can account for why some patients improve quickly on a medication, while the same medicine may make another patient feel worse.
Psych Choices of the Delaware Valley has been one of the pioneers in utilizing genetic testing to help our doctors select which medicines are the best match for each patient. We use a test called GeneSight, by Assurex Health.
This test involves a simple cheek swab. A medical assistant will collect the swab using a cotton-tipped applicator, and a sample of your saliva is then sent to the GeneSight lab for processing.
The test analyzes eight genes of a person’s DNA from a simple cheek swab to determine what that person’s likely response and exposure level, or rate of metabolism, will be to 55 different anti-depressants, anti-anxiety medications, mood stabilizers and anti-psychotics, as well as 22 types of pain pills, and eight ADHD medications. The test also reveals how well one metabolizes folic acid (l-methyl folate), which is important to recovery from depression and overall brain and body health.
Those medications are then ranked in categories of green (for best response), down to yellow (use with caution) and red (for least effective or riskiest).
Studies have shown that when doctors used GeneSight to help guide their medication decisions, their patients were twice as likely to respond to the selected medicine. Plus, these patients saw a 70% greater improvement in their symptoms than those whose medications were chosen by the usual, “trial and error” method!
The GeneSight company started as “six guys working in a garage” some years ago; now they are able to test over 150,000 patients nationally. At Psych Choices, we’ve been using GeneSight since February 2012, almost since it first became available.
“Many patients come in with a list of medications they have tried and the various side effects they have experienced,” explains Dr. Erica Borman of Psych Choices. “Others worry about having to try so many before finding the right one for them. Having Genesight testing has allowed me to personalize the care I give to patients by knowing how they are likely to respond to a medication based on their specific genetic profile. Ultimately this leads to finding the right medication more quickly.”
Dr. Noah Freedman, Psych Choices founder and medical director, appreciates especially how GeneSight can help determine the safest medications for patients who may have attention deficit disorders (ADHD). “These patients are often prescribed medications which carry high risk of addiction and cardiovascular side effects,” comments Dr. Freedman. “It is useful to have tests which help us find the safest medications for ADHD.”
And the best medications now can be found with much less trouble and expense! According to GeneSight’s research, patients who had been taking a medication which was later found to be categorized as “red” by the genetic test had three times the number of sick days from work; 69 percent more doctor visits; four times the number of disability claims; and spent $5,188 more per year on health costs.
Generally, the test will be recommended once a patient has tried one or two without success. The testing can be expensive, but with the financial arrangements offered by GeneSight, the patient’s cost will never be more than $330.00, and depending on family income, can often be as low as $20. The testing is now covered by Medicare and increasingly by other insurance plans. If your insurance doesn’t cover it in full, your co-pay is capped depending on your income, which is requested by the company using the honor system. If you have this test performed in our office, you will be provided with a folder explaining all the financial information and options, including a payment plan for the $330.00 if that is your fee.
To make an appointment with a psychiatrist at Psych Choices of the Delaware Valley for an evaluation, which may include GeneSight testing, please call us at 610-626-8085, or use our “Schedule an Appointment” page.
ASSUREX HEALTH’S CLINICAL STUDIES: BY THE NUMBERS
- 50 percent of patients with depression don’t respond to first treatment
- 30 percent of patients stop treatment due to intolerable side effects
- Doubles a patient’s odds of responding to treatment
- 70 percent or higher reduction in depressive symptoms
- $2,500 reduction in annual health care costs
- 14 percent lifetime prevalence of major depressive disorder in those 13 and older