GeneSight testing gives us a preview of how to handle starting a new drug

I am David Merrill. I am an adult and older adult psychiatrist. I focus mainly on middle-aged and older adults who suffer from anxiety and depression who may also be starting to notice changes with their memory.

As we get older, the ability of our bodies to stay in balance diminishes. It’s more and more difficult to be experimenting with new drugs because the likelihood or probability of their causing an adverse event or a side effect goes up.

What the GeneSight test does is give us a preview on starting a new drug and whether it’s really critical to start low and go slow, or whether or not we can anticipate that this is a drug the patient is more than likely able to tolerate.

This was a case that we saw that my patient had been suffering for decades. I had the good fortune of meeting her at a time when GeneSight was just coming out as a commercially available product and she was agreeable to do the testing. In fact, she was interested to know what could possibly be going on that she was unable to tolerate even low doses of very commonly prescribed medications that her doctors had told her “Don’t worry, this medication will be easy to take. There won’t be a problem with the side effects.” Then she would have to come back and explain how she wasn’t able to tolerate the medications.

So once the GeneSight report became an option, we sent off the testing and the results came back suggesting a new approach. And we did try one of the drugs that was in the “Use as Directed” category. She was actually able to achieve full clinical remission from depression, which then allowed us to work harder on the psychology of her case and talk through events and past emotional processes that she hadn’t been able to access in the context of an active episode of depression.

What can be helpful with these tests is to share that moment with the patient and allow them to form that bond with you–clinician to patient–that they might not otherwise have. It can help me explain to the patient using the objective data what is going on.