Guest blog: Access to genetic test impacted treatment, improved depression remission
MHA Admin Tue, 02/07/2023 – 13:04
The process of finding a medication that works can be frustrating, time-consuming, and debilitating. In fact, according to the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project, fewer than 50% of individuals with depression respond to their first medication. A PGx test, or pharmacogenomic test, analyzes how genes may affect medication outcomes and can inform clinicians about how a patient may break down or respond to certain medications commonly prescribed to treat depression, anxiety, ADHD, and other psychiatric conditions.
In July 2022, the U.S. Department of Veterans Affairs (VA) shared the results of a study of nearly 2,000 veterans that investigated whether access to PGx results impacted treatment decisions and improved patient outcomes for those with major depressive disorder (MDD). The PRIME Care study, published in the Journal of the American Medical Association (JAMA), used the GeneSight test as the PGx test.
How the GeneSight test works
Let’s first discuss how the test works. The GeneSight Psychotropic test can help inform clinicians about genes that may impact how patients metabolize or respond to certain depression, anxiety, ADHD, and other psychiatric medications. The GeneSight report shows whether there are gene-drug interactions for 64 FDA-approved psychotropic medications.
For example, a patient’s unique genetic profile can help determine the rate at which their body may metabolize certain psychiatric medications. If a medication is broken down at a faster rate than normal, the patient may not have enough in their body, which may be ineffective for treatment. If a medication is broken down at a slower rate than normal, the patient may have too much in their body, which may lead to side effects.
Patients in the GeneSight test group were more likely to achieve remission
One of the PRIME Care study’s co-primary endpoints showed that, over 24 weeks, the group whose clinicians had access to the GeneSight test had a 28% greater likelihood of achieving remission from depression symptoms than the “treatment as usual” (TAU) group.
Remission in the study was defined as a score of five or less on the PHQ-9 depression symptom questionnaire. The PHQ-9 is a standard patient questionnaire designed to determine the level of severity of depression in a patient. It asks patients to rate things, based on the past two weeks, like “little interest or pleasure in doing things,” “feeling tired or having little energy,” and “feeling bad about yourself – or that you are a failure or have let yourself or your family down,” on a scale from zero to three, where zero is “not at all” and three is “nearly every day.”
Patients in the GeneSight group were less likely to be prescribed medications with predicted gene- drug interactions
Gene-drug interactions are important because they can inform clinicians about a patient’s ability to metabolize or respond to a certain medication. The PRIME Care study’s other co-primary endpoint showed that patients in the “treatment as usual” group were approximately two-fold more likely to be prescribed medications with predicted substantial gene-drug interactions compared to the GeneSight group in the first 30 days after randomization.
Easy for the patient, valuable tool for clinicians
A health care provider who can prescribe medications must order the GeneSight test kit. A DNA sample is collected through a simple cheek swab in a clinician’s office or in the patient’s home and sent to the GeneSight lab for analysis. After the GeneSight team receives the sample, the clinician will typically get test results in about two days.
If a clinician is considering medication for someone struggling with depression, this test can help inform their treatment decisions and may help limit the trial-and-error-process. The comprehensive GeneSight Psychotropic report proves information about which medications may require dose adjustments, be less likely to work, or have an increased risk of side effects based on the patient’s genetic information.
Learn more about at GeneSight.com.
Disclaimer: The GeneSight test is intended to supplement other information considered by your doctor within the context of a comprehensive medical assessment. Tens of thousands of clinicians have used the GeneSight test to help inform treatment plans for more than 2 million patients. Not all patients who receive the GeneSight Psychotropic test will be prescribed medications with no or moderate gene-drug interactions. Not all patients who receive the GeneSight Psychotropic test will experience remission.
Holly Johnson, Ph.D., is the director of medical information at Myriad Mental Health.
The views and opinions expressed in this blog solely belong to the author and content in outside links does not necessarily reflect the views of Mental Health America.