Am I a Good Candidate for GeneSight Testing?

The GeneSight test is a genetic test that can help inform your doctor about genes that may affect how you metabolize or respond to certain medications commonly used to treat depression, anxiety, ADHD and other mental health conditions. The test is intended to supplement other information considered by a doctor as part of a comprehensive medical evaluation. Your psychiatrist, primary care physician, or other healthcare provider can determine if you are a good candidate for this testing.

Who Qualifies for GeneSight Testing?

Patients who have failed one or more medications:

GeneSight test results were validated among patients in clinical trials who were not responding to their medications.^1–5  If you are a patient who has failed one or more medications, the GeneSight test can provide a roadmap for your healthcare provider to identify medications or medication classes to which you are most likely to respond.

Elderly patients and those with liver damage:

Elderly patients⁶ and patients with liver damage⁷ may have impaired production of liver enzymes, which can affect the rate a drug is metabolized and intensify the effects of genetic variations.  GeneSight testing gives healthcare providers genetically informed dosing guidance that can be used in addition to their revised dosing range for these patients. The GeneSight test has also been shown to significantly reduce polypharmacy (the taking of multiple medications)⁵, which can be common in elderly patients.

Patients who are very sensitive to medications:

Side effects from medications may result from the way a drug interacts with your body, the way your body impacts a drug, or even from psychological factors⁸. Many healthcare providers use the GeneSight test to shed light on this process for potential solutions.

When Should Caution Be Used with the GeneSight type?

Patients who have failed numerous medications in multiple classes:

The GeneSight test may explain why you have failed past medications and may validate your experience. If you have already tried many medications, the GeneSight test is less likely to identify a medication you have not yet tried. However, it may identify medications that a healthcare provider may re-try at an adjusted dose.

Patients with a liver transplant:

The GeneSight test looks at the DNA of the patient, while a transplanted liver has the DNA of the donor.

The GeneSight test provides accurate information regarding how medications used to treat depression, anxiety, ADHD and other psychiatric conditions affect your body. However, your healthcare provider will not gain useful information from the part of the test that reports how your body breaks down medications. This is because it reflects how you would break down medications based on your DNA, not the donor’s DNA.

Since the overall results of the GeneSight test depend on both parts of the test, the report that separates medications into the green, yellow, and red categories may not be used by your provider to guide medication decisions.

Therefore, liver transplant patients should only consider the GeneSight test if their healthcare provider believes benefit can be gained from the part of the test covering how certain medications impact the patient’s body.

Who is Not Appropriate for the GeneSight test?

Patients who are already doing well on their current medications are not ideal candidates for the GeneSight test.

The GeneSight test should be used when your healthcare provider is considering adjusting, augmenting or discontinuing your medication. 

Questions?

For more information on how the GeneSight test can help you and your physician, visit genesight.com, email us at medinfo@assurexhealth.com, or phone 855.891.9415.

References

1. Hall-Flavin, D. K. et al. Using a pharmacogenomic algorithm to guide the treatment of depression. Transl. Psychiatry 2, e172 (2012).
2. Hall-Flavin, D. K. et al. Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting. Pharmacogenet. Genomics 23, 535–48 (2013).
3. Winner, J., Allen, J. D., Anthony Altar, C. & Spahic-Mihajlovic, a. Psychiatric pharmacogenomics predicts health resource utilization of outpatients with anxiety and depression. Transl. Psychiatry 3, e242 (2013).
4. Winner, J. G., Carhart, J. M., Altar, C. A., Allen, J. D. & Dechairo, B. M. A prospective, randomized, double-blind study assessing the clinical impact of integrated pharmacogenomic testing for major depressive disorder. Discov. Med. 16, 219–27 (2013).
5. Winner, J. G. et al. Combinatorial pharmacogenomic guidance for psychiatric medications reduces overall pharmacy costs in a one year prospective evaluation. Curr. Med. Res. Opin. 1–30 (2015). doi:10.1185/03007995.2015.1063483
6. Sotaniemi, E. A., Arranto, A. J., Pelkonen, O. & Pasanen, M. Age and cytochrome P450-linked drug metabolism in humans: An analysis of 226 subjects with equal histopathologic conditions. Clin. Pharmacol. Ther. 61, 331–339 (1997).
7. Prescott, L. F., Forrest, J. a, Adjepon-Yamoah, K. K. & Finlayson, N. D. Drug metabolism in liver disease. J. Clin. Pathol. Suppl. (R. Coll. Pathol). 9, 62–65 (1975).
8. Mitsikostas, D. D., Mantonakis, L. & Chalarakis, N. Nocebo in clinical trials for depression: A meta-analysis. Psychiatry Res. 215, 82–86 (2014).