Pharmacogenomics Testing

by ih-mmd ih-mmd

What is pharmacogenomics?  Pharmacogenomics uses information about your individual genetic makeup to help your doctor choose medications and medication doses (pharmacology) that are most likely to work best for you.  The use of pharmacogenomics testing helps reduce the traditional trial and error treatment done in traditional psychiatry. 

When you take a medication your liver releases enzymes to break it down in order to remove it from your body.  This is why you must take medications in the same way each day to maintain the proper and consistent amount of medication in your system.  Every person’s genes create enzymes that breakdown medication at varying rates.  The rate of breakdown has a direct effect on how much of the medication stays in your system and the benefit you may derive. 

There are 4 kinds of metabolizers (Phenotypes).  These 4 types represent the rate at which a person is able to break down and use the medication in the body. 

  • Ultra-rapid metabolizers:  These individuals will breakdown medications rapidly and may not get enough medicine at the normal dose; these individuals may need higher doses of medication to achieve the same result.
  • Extensive metabolizers (normal):  These individuals breakdown medications normally a have the normal amounts of medication at normal doses. 
  • Intermediate metabolizers:  These individuals take longer to breakdown medications and they may have too much medication at the normal dose these individuals require much lower doses and a longer period of time to achieve the same effect as a normal metabolizer. 
  • Poor metabolizers:  These individuals breakdown medications very slowly and may never experience therapeutic effect and may even experience side effects much sooner than normal metabolizers.

What is a gene?  A gene is a DNA sequence that codes for a specific protein

Genes also make proteins in your brain that are used by medications to have their intended effect. Changes in these genes may affect your chance of responding to medications as well as your chance of having side effects.  Because medications are metabolized through multiple genetic pathways different individuals may have different active and inactive pathways which would explain why the individual is having or not having a specific affect. 

What is an allele? A version of the gene

What is an enzyme?  A protein that works to produce a specific biochemical reaction

The diagnosis of a psychiatric condition is based on a constellation of symptoms that when presenting in a specific manner are classified as a syndrome which is called a psychiatric condition. However, many of the same symptoms manifesting in psychiatric conditions can be caused by underlying medical conditions. Given all this ambiguity it is essential to be evaluated by an expert in the field who can employ genomic testing to bring diagnostic clarity and treatment specificity.