For the 1 in 10 Americans diagnosed with depression, choosing the right antidepressant is no easy feat. The 20-plus mental-health drugs approved by the U.S. Food and Drug Administration all carry side effects and can interact negatively with other treatments. And certain drugs simply work better for some people than others.
For doctors, matching patients with the right drugs is an inexact science, at best. Patients may try many drugs – sometimes in various combinations and dosages – before hitting on the best option. For some, it is a grueling trial-and-error ordeal that lasts months or longer.
But that may all be about to change. A remarkable new test developed at the Mayo Clinic and Cincinnati Children’s Hospital is now available that helps turn the subjective method of selecting the right antidepressant into a more exact process.
The GeneSightRx test is the first “pharmacogenomic” laboratory test that can help guide patients to antidepressants likely to be a good or bad match, based on his or her individual genetic makeup. Created by an Ohio-based company called AssureRx Health Inc., it is being hailed as a breakthrough in therapy and one of the first practical examples of what experts have long viewed as the wave of the future in healthcare – treatment that is personalized to an individual’s biological makeup.
“Pharmacogenomics is being use to improve mental wellness so it is already one of the waves of the future for personalized medicine,” AssureRx’s Chief Science Officer Tony Altar told Newsmax Health. “Its application is already here.”
How the test works
Psychiatrists prescribe various kinds of antidepressants that have different effects on chemicals in the brain called neurotransmitters – including serotonin and norepinephrine – which are believed to regulate moods. The most commonly prescribed antidepressants are called SSRIs (short for selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). They work by increasing the activity of the brain chemicals through varying mechanisms, requiring the activity of different enzymes.
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But genetic differences can determine how a person will react to mental-health medications. Doctors have known this for years. In fact, they often find that when depression runs in families, the same antidepressant medication will work best on all family members who have the condition.
GeneSight identifies variations in a small number of genes that influence the metabolism and therapeutic response of drugs used to treat depression, as well as schizophrenia and attention deficit hyperactivity disorder, said Altar. By tracking liver enzymes that degrade the drug once it is in the body, the test can predict how a patient will react to specific antidepressants.
“In the case of therapeutic response, the prediction is based on how the gene variation affects brain proteins that contribute directly to the therapeutic response of the drug,” he said. “The [test] can predict psychiatric drugs that are or are not a good match for treating patients, based on each patient’s genetic profile.”
To use the test, patients work directly with their own doctors, who take a saliva sample and send it directly to AssureRx for analysis. Within 24 hours, the company provides results, including the most commonly prescribed drugs he or she is likely to respond well to and tolerate, and a drug interaction table indicating any potential conflicting substances.
“The test has to be ordered by a clinician who is licensed to prescribe medications such as a physician, nurse practitioner, physician assistant, and in some states a Ph.D. psychologist can get a license to prescribe certain types of medications,” Altar noted. “The patient cannot order the test.”
For more information: Visit AssureRx’s Website at www.assurerxhealth.com or call 513-234-0510. Patients can ask their doctors to contact AssureRx by calling 866-757-9204 or e-mailing sales@assurerxhealth.com.
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