Genetic Testing & the Choice of Anidepressant

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For over 30 years, they've been praised to the sky and vilified as virtual poisons. Antidepressant - few drugs, since the era of antibiotics arrived in the wake of the second world war, have received as much media attention. At the recent annual meeting of the American Psychiatric Association, a study was presented that is likely to continue the debate. It is argued that patients with treatment-resistant, major depressive disorder (MDD) were 30% more likely to respond to treatment, and 50% more likely to achieve remission, when their medication selection was guided by the GeneSight psychotropic genetic test.


Currently, trial-and-error prescribing of antidepressants is the norm. Such a practice is a contributing factor in treatment failure and increases costs. The GeneSight test combines personal genetic data with medication information to tailor which antidepressant should be prescribed. The information involves 12 genes and 56 medications. DNA samples are taken with cheek swabs, sent to a laboratory, and returned in 36 hours with a significant gene interactions identified.


The study included 1167 outpatients with moderate to very severe, treatment-resistant depression for whom at least one antidepressant had failed. Most participants had at least three treatment failures. At eight weeks, symptom improvement was seen in the GeneSight cohort, and improvements in rates of response and remission were "significantly greater" in the GeneSight cohort.

"Genetic Test Identifies Best Antidepressant," Medscape, May 7, 2018, https://www.medscape.com/viewarticl...507_MSCPEDIT&uac=291811EY&impID=1626579&faf=1
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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