HomeGenetic InsightsFactors that May Impact Medication Response Factors that May Impact Medication Response January 22, 2020Genetic Insights Treating Depression How the human body responds to the medications used to treat depression is very complicated. First, there’s a lot we don’t know about depression. According to Harvard Health: “Research suggests that depression doesn’t spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. With this level of complexity, you can see how two people might have similar symptoms of depression, but the problem on the inside, and therefore what treatments will work best, may be entirely different.” Additionally, the body’s ability to respond to the medications is impacted by many factors such as drug/drug interactions, food/drug interactions, lifestyle factors, age, allergies – and your unique genetic code. The last factor is where the GeneSight test comes in. The GeneSight test is a pharmacogenomic test that analyzes how your DNA may affect outcomes with depression medication. The GeneSight test can help inform your doctor about which medications may require dose adjustments, may be less likely to work, or may have an increased risk of side effects based on your genetic makeup. However, the GeneSight test results are not meant to be the only source of information your doctor considers when selecting a new medication. The GeneSight test is intended to supplement other information considered by your healthcare provider as part of a comprehensive medical assessment. Medication Response Factors There are numerous other factors that may impact how a patient may respond to medications, including: Drug/drug interactions– a drug/drug interaction could potentially occur when you are taking multiple medications at the same time. One medication may impact how your body metabolizes another medication. According to Harvard Health, “a drug, supplement, or food may affect how long a medication stays in the body, often by stimulating or inhibiting the production of specific enzymes in the liver or intestine. These enzymes are part of the cytochrome p450 system, which plays an important role in metabolizing many medications.” Food/drug interactions– similarly, what you eat could impact how well you metabolize certain medications. “Some food products are fortified with vitamins and/or minerals that can interact with certain drugs,” states an article in U.S. Pharmacist. “There are hundreds of drug/nutrient interactions.” Some examples of nutrients and foods that can interact with medications are grapefruit juice, caffeine, protein-rich foods or high-fat meals. Lifestyle factors– smoking and other lifestyle factors can contribute to how your body metabolizes certain medications. For example, tobacco smoke “induces many of the CYP450 enzymes in the liver, which play an important role in medication absorption, distribution, metabolism, and elimination,” according to an article in Pharmacy Times. “Psychiatric medications such as antipsychotics, antidepressants, hypnotics, and anxiolytics are widely affected by cigarette smoking.” Mixing alcohol and psychotropic medication can have a detrimental impact. “Many medications can cause problems when taken with alcohol – including anti-anxiety medications, sleep medications and prescription pain medications. Side effects may worsen if you drink alcohol and take one of these drugs along with an antidepressant,” warns the Mayo Clinic. “When combined with certain types of alcoholic beverages and foods, antidepressants called monoamine oxidase inhibitors (MAOIs) can cause a dangerous spike in blood pressure.” Age– Your age is another factor that may impact outcomes with certain medications. The FDA states: “as you get older, body changes can affect the way medicines are absorbed and used. For example, changes in the digestive system can affect how fast medicines enter the bloodstream. Changes in body weight can influence the amount of medicine you need to take and how long it stays in your body. The circulatory system may slow down, which can affect how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly, affecting the way a drug breaks down and is removed from the body.” Allergies– Allergic reactions to medication is another factor for your doctor to consider. The Mayo Clinic indicates that a “drug allergy is the abnormal reaction of your immune system to a medication… The most common signs and symptoms of drug allergy are hives, rash or fever. A drug allergy may cause serious reactions, including a life-threatening condition that affects multiple body systems (anaphylaxis)… a drug allergy is not the same as a drug side effect, a known possible reaction listed on a drug label.” Considering a Patient’s Entire Clinical Profile Both healthcare providers and patients should note that it is important to take into consideration a patient’s entire clinical profile for medication selection, including the factors listed above. It is also important to note that all medications come with their own risk of side effects. While genetics is able to provide some insight, it cannot tell us the “best” medication for a patient. The GeneSight test can help inform medication selection, but it cannot and should not be used as the only consideration in medication selection, as genetics is only one part of the puzzle. For more information about the GeneSight test, visit genesight.com, email us at [email protected], or phone 855.891.9415. This document is for educational purposes related to pharmacogenomics and personalized medicine only and should not be considered medical advice. The information is based on scientific opinion from industry experts and is intended to provide additional information to healthcare providers. These materials may be changed, improved, or updated without notice. Myriad Neuroscience is not responsible for any errors or omissions contained in third party content. We encourage you to contact us for specific scientific advice regarding our GeneSight® tests. You may print a copy of this document for your own personal noncommercial use. You may not copy any part of this document for any other purpose, and you may not modify any part of this document without the permission of Myriad Neuroscience. “GeneSight,” “Myriad Neuroscience” and associated logos are registered trademarks of Myriad Neuroscience. © 2019 Myriad Neuroscience. All rights reserved. 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Patient MTHFR Mutations: Clinical Implications and Management Strategies MTHFR mutations—changes in the methylenetetrahydrofolate reductase (MTHFR) gene—have gained increased attention in the medical community due to their potent... Read more
Patient Can an App Help Me Manage My Anxiety? Health and wellness smartphone apps have become so common that if you can name a health goal, desire or condition, you can probably find an app for it. N... Read more
Patient Black Trailblazers of Psychiatry and Mental Health: A Legacy of Healing and Advocacy As we celebrate Black History Month, we want to recognize a few individuals who have made extraordinary contributions to the field of psychiatry and mental heal... Read more
Patient Mindful Moments: Tips for Anxiety If a well-meaning friend or family member has ever told you to “just breathe” when you’re feeling worked up or stressed out, you’d be forgiven if you felt l... Read more
Patient Hints To Help You Have A Better New Year The holidays have ended, and a new year has begun—a time when many embrace a fresh start by setting New Year’s resolutions. This year, why not consider s... Read more
Patient Movement as Medicine: Solutions for Anxiety Moving forward. It sounds like a nice idea, especially when you’re feeling stuck deep in the throes of an anxiety spiral. But it turns out that physically m... Read more
Patient Weight-Loss Drugs and Mental Health: What You Need to Know New medications for weight loss seem to be flying off pharmacy shelves these days. But could they be linked to mental health conditions? Researchers are ... Read more
Patient 3 million patients (and counting!) have now taken the GeneSight test! We’re thrilled to share that 3 million patients (and counting!) have now taken the GeneSight test! We're so grateful to the dedicated healthcare providers who... Read more
Patient The Model Minority Myth and Mental Health The model minority myth stereotypes one cultural group, typically Asian Americans, as “intelligent, hard-working, and diligent and therefore more academically, ... Read more