Genetic testing could help patients find better treatment for depression, psychiatrist says

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GREENVILLE, S.C. (WSPA) – A Greenville psychiatrist said pharmacogenomic testing could help patients find better treatment for major depressive disorder, particularly if they are not noticing any improvement or are noticing negative side effects from their medication.

“By just doing a simple cheek swab, the provider could get a list of the medicines that would have no gene-drug interaction and could be used safely, versus a significant or severe gene-drug interaction that maybe you’d want to stay away from,” Bon Secours St. Francis Psychiatrist Dr. Carson Felkel said.

That kind of genetic testing, he explained, involves a cheek swab that is sent off to a lab and can show doctors which anti-depressant medications may be best for a patient based on his or her DNA.

“It really can help primary care as well as psychiatry,” he said. “It helps to eliminate the guesswork and get on the right medication earlier on in a treatment.”

Dr. Felkel explained that everyone metabolizes medicine differently and said sometimes, the way drugs interact with a person’s DNA can cause negative side effects.

“People respond to medicines differently in part because they have different blood levels of the medicine in their system, and it’s usually our liver that changes the blood level as it breaks down the medicine,” he said. “Everyone metabolizes medicines differently and that’s all based on DNA, so now we can prescribe a different dose of medicine based off of your own genetics,” he said. “A lot of medicines have side effects, many of them severe, so it’s important to get on a medicine that has less significant gene drug interactions.”

A 2018 study from the the Korean College of Neuropsychopharmacology suggests that this kind of testing may offer better treatment and a higher chance of remission for major depressive disorder, although it says more studies are needed.

“The idea of knowing how the liver metabolizes medicines is not new; it’s been around a long time,” Dr. Felkel added. “The technology is always evolving. As new medications come out, it’s now able to dose them differently, or prescribe maybe a completely different medicine based on someones DNA.”

Dr. Felkel believes pharmacogenomic testing could be helpful for patients not just suffering from depression, but anxiety and sleep issues as well.

“The technology can also help anyone that suffers from anxiety or sleep issues because it also tells us how your body metabolizes those medicines,” he said.

If you think you could benefit from this kind of testing, he recommends that you ask your doctor or psychiatrist about pharmacogenomic testing. He said it is not always covered by insurance, but is more affordable than it once was.

“It used to be a cost prohibitive technology where it would cost thousands of dollars,” Dr. Felkel said. “Now its a lot more affordable, [costing] hundreds of dollars at the most, if not less, based off of someone’s income.”

Dr. Felkel’s practice uses the company GENESIGHT to process pharmacogenomic testing.

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