Genetic Testing and Mental Health
National Human Genome Research Institute
Genetic testing is growing in popularity. The use of this testing in psychiatry and mental health can provide individualized information about how medications may affect the body and how the body may affect medication action. At this time gene testing in psychiatry is not diagnostic of any condition. It can, however, detect gene variations that may modify how well a medication may or may not work for a person and possibly influence side effect risk.
There are many factors besides gene variation that can alter a person’s response to medications. These factors include age, gender, diet, pregnancy, smoking, substance abuse, medical conditions and other medications a person may be taking. It is important to know that although gene variation may be present, if the gene is not active, the effects of that variation will not be expressed.
So why gene test? One of the goals for successful treatment is to find the most effective medication for an individual. Knowledge of genetic variation prior to treatment can help reduce “trial and error”.
Unfortunately, most insurance companies will not cover genetic testing for psychiatry. At this time the majority of testing is done for individuals who have history of multiple medication use with poor or no response or adverse side effects. The Food and Drug Administration (FDA) does recommend gene testing prior to use of certain medications, including some used in psychiatry.
Although insurance companies may not cover the cost of testing, many companies that provide the lab testing offer patient assistance to make the cost affordable. What kind of genes are tested for? There are genes that influence breakdown of drugs, that is getting the medication into, through and out of the body. If a person is identified to be a rapid or slow metabolizer of certain medications, this can alter therapeutic levels in the body and require adjusting the strength and timing of doses.
Variations of genes may also influence how a drug might interact with other medications and possibly alter response to medication or increase risk of side effects. Other gene variations may indicate risk for certain symptoms or increased risk of side effects with certain medications.
How is the testing done? It’s a simple cheek swab for saliva collection, and results are generally returned within one week. It is important to sit with the provider to review results and how those apply to the individual. In summary, gene testing is not diagnostic of any psychiatric condition. Individuals experiencing difficulty with effective treatment may be the best candidates for testing.
Karen Van Wie , PMHNP-BC is a psychiatric nurse practitioner providing services for children, adolescents and adults through her private practice at InnSæi: Health for Mind and Body. She offers genetic testing. Connect at 520-343-2105 or InnSaeiHMB.com.