How Genetic Testing Will Transform Mental Health Care
Genetic testing helps physicians to identify more personalised and precise treatment options, ultimately improving psychiatric patient outcomes.
Renowned biochemist and Nobel Laureate Paul Berg said, “I start with the premise that all human disease is genetic.” Indeed, advances in medicine have seen the transformative utility of genetic testing for cancer and other medical conditions. However, genetic testing has only recently seen utilisation in psychiatry. The complexities of our brain have long eluded precise examination and treatment.
For people with mental illness and their loved ones, the journey to better health can be a long and troubled passage. Patients and their caregivers can face stressful days and restless nights, filled with profound physical and emotional challenges.
For the more than 46 million American whose lives are impacted by mental health conditions, the burden can be costly as well. According to an editorial in the American Journal of Psychiatry, serious mental illnesses cost patients more than $193 billion per year in lost earnings. The emotional cost is boundless
Currently, in hospitals all over the world, many drugs that are currently available are “one size fits all,” but they don’t work the same way for everyone.
It can be difficult to predict who will benefit from a medication, who will not respond at all, and who will experience negative side effects (called adverse drug reactions). Often, a patient must return to their doctor over and over again until the doctor can find a drug that is right for them. In the United States, adverse drug reactions are the fourth leading cause of death in hospitalised patients, one in four prescribed drugs could harm a patient and are annually responsible for hundreds of thousands of deaths and US$136 billion per year in added costs.
Genetic testing services are cost-savers that will create sector-wide efficiencies. It's totally different from the traditional way of prescribed medications. Pharmacogenomics testing is re-shaping traditional care by replacing the trial-and-error method of finding the right drug and or dose for patients. Doctors use pharmacogenomics testing to provide personalised medicine rather than using the population-based or one size fits all approach. The pharmaceutical companies and hospitals will save money because the pharmacogenomics testing results will allow the doctor to prescribe a more accurate dose of medication minimising waste
Genetic testing has become increasingly popular among doctors who prescribe psychiatric medication, in particular antidepressants. Finding the right mental health medication can sometimes be a slow process full of unpleasant side effects. Roughly 40% of people who take an antidepressant will stop taking the medication within the first three months because of side effects or because they believe the medication is ineffective. People who take antidepressants often complain of unpleasant side effects like nausea, sexual dysfunction, headaches, drowsiness, dry mouth, and increased anxiety. When a person experiences side effects, it is easy for them to become discouraged and assume that no medication will help their condition.
Genetic testing can reduce the pain of trial and error
The financial and emotional strain of prolonged treatment failure worsens the struggle for many people with mental illness. Unfortunately, this is an unintended consequence of psychiatric practice that often utilises an informed trial-and-error process in selecting medications.
Going through many iterations of medicines unsuccessfully often deepens a patient’s sense of despair and hopelessness. For some patients, it may take months or years to get to the right regimen.
I’ve witnessed the impact on patients and their families firsthand. It’s not uncommon for our practice to see about 40 new patients a month, 70% of whom have been treated by between one and thirteen other doctors.
These patients have suffered through many medication missteps. I even had one patient who had been on fifteen different psychotropics in the last three to four years, none of which helped, and some of which made him worse.
The challenge of treatment resistance
Shortening the time it takes to get a patient on the right medicine, or combination of medications can do more than just treat their condition. It can also help avoid the risk of further emotional and cognitive decline and even prevent dementia or suicide.
However, achieving greater precision in prescribing drugs for mental health conditions can be a daunting task for any clinician, particularly when it involves treatment-resistant patients who go through multiple rounds of failed medications.
Addressing the challenge of treatment resistance is critical to stemming the burgeoning mental health crisis in the U.S. The Centers for Disease Control and Prevention predicts that 50% of all Americans will be diagnosed with a mental illness or disorder at some point in their lifetime.
What makes this forecast more stark is the fact that an estimated two out of three people with depression will be prescribed an ineffective medication at the start of treatment. And, one in three people will become treatment-resistant. This is according to a study published in the American Journal of Managed Care. The same study also showed that people who are resistant to treatment will pay 40% more in healthcare costs.
Embracing innovation in mental health care
To improve the process of prescribing drugs for mental health conditions, doctors are increasingly utilising new technologies like genetic testing to enhance their decision-making. Genetic testing brings much-needed innovation to the classic approach to treating psychiatric conditions that rely on treatment guidelines, physician training, population-based studies, and trial-and-error.
It augments diagnostic-specific treatment strategies and personalised patient data, such as symptom profile, family history, and past responses to medications, with precision medical information that is based on a patient’s personal genome. Since each person’s response to medicine can be impacted by their genetic variations, genetic testing provides actionable information that narrows the choice of medication for each individual patient.
While no single test enables a psychiatrist to prescribe with surgical precision, genetic testing makes us more precise prescribers. It identifies which drugs that are more likely to work and which are more likely to have unwanted side effects. This can shorten the time it takes to prescribe the most effective medication. Each day saved is one less day of emotional torment for patients and their loved ones.
Genetic testing and mental health: What you need to know
Genetic testing is designed to be easy and painless. To complete the test, clinicians will collect a small sample of blood or saliva from the patient. Each person responds differently to prescription medications. Genetic testing uses genetic information about a person's genetic makeup to choose the drugs and drug doses that are likely to work best for that particular person. Delivering immediately accessible and medically actionable information,
Genetic testing results provide optimal drug selection and dosage based on an individual’s genetic profile. By screening an individual’s DNA, personalised results decrease the risk of adverse drug effects while expediting effective patient treatment, Genetic testing may also help to save time and money.
By using information about a person's genetic makeup, doctors soon may be able to avoid the trial-and-error approach of giving you various drugs that are not likely to work for patients until they find the right one. Using PGx testing, the "best-fit" drug to help you can be chosen from the beginning. We utilise the latest in genotype technology coupled with a cutting-edge clinical team to deliver on our belief “right drug and right dose at the same time to decreased side effects" for every patient. Genetic testing is driving a paradigm shift in the personalised treatment of mental illness. As more and more doctors rely on genetic testing to support drug selection for mental health conditions.
Genetics Healthcare Centre is an innovative company as we have provided the technology to help doctors identify the right drug and the right dosage for cardiovascular diseases, diabetes, gastrointestinal diseases, urologic diseases, mental health, immunological diseases and pain management that provides clinically relevant data for personalised treatment and cost-effective strategies based on an individual’s DNA.