“I feel GeneSight should become standard of care.”

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The practice of medicine can be very complex. You’re frequently dealing with patients with multiple comorbidities on lots of medication. Decision making can be difficult. Dealing with patients in psychiatry, frequently, it’s difficult to choose the right modality for that patient due to inefficacy of treatments, side effects, and other factors. When I saw that GeneSight was first available, it piqued my curiosity. I spoke with people at the company and they educated me about how to use the GeneSight assay.

The literature about GeneSight is impressive. However, when I first saw it in my practice, that’s when I was sold. It really works amazingly well. It’s helped me predictively in choosing the right medication for a patient. It’s also validated patients who have tried multiple medications in the past and didn’t know why medications didn’t work for them. Patients metabolize medications through different pathways. These pathways are determined by enzymes. If a patient is a poor metabolizer at a certain enzyme system, we’re not going give them the medication that’s metabolized by that system because we know we’re going to get poor results and side effects. What we use the GeneSight assay to do is to find what pathways the patient has a robust response to. Therefore we can pair the correct medication with the patient’s genetics for an optimal result. It takes the guesswork out of the medication management.

Patients can’t believe it when I tell them about the GeneSight assay. What I say to them is, “Hey, listen, I’m gonna swab the inside of your cheek, collect some cheek cells. I’m gonna send those cheek cells off to the lab. They’re going to look at the DNA in those cheek cells, and then they’re going to send me a report telling me which medications you have a better likelihood of tolerating, and which medications you have a better chance of benefiting from. It used to be that patients have to go through months and months if not years of trials after trials after trials. Now, frequently, we’re able to get the right medication for the patient with the first try.

We talk about individualized medicine all the time, but rarely are we able to practice it in such a way as we can with GeneSight. We can try tailoring treatments to individual patients, but we rarely have this type of scientific evidence as provided by the GeneSight assay. I feel like GeneSight should become standard of care. Why would you not want to perform the most-informed medicine that you can? If you have information at your fingertips which will optimize your patient’s care, I think we’re hard-pressed not to use it.

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