I realize that I don’t often talk about the testing I do on my patients. And I suppose it’s out of habit.
You see, many of the tests I use are cutting edge and haven’t really made it to the mainstream just yet. So I end up getting a lot of flak from conventional physicians for using them. (Because if they don’t know anything about the test, then anything that anyone else knows about it is just plain wrong…)
Of course, after three decades, I’m used to these slings and arrows. But I’m also used to being right about most things long before conventional medicine even has a clue. And in case you haven’t guessed, this is another one of those times…
Guided treatment gets better results
For years, I’ve been using pharmacogenomic testing to guide me in prescribing the most effective antidepressants for my patients. And the reason why is two-fold.
First and foremost, as I’ve mentioned here many times before, antidepressants are a nasty class of drugs in general. The best course is to avoid them altogether—if you can.
But as with any drug, there may be times when they’re necessary. And if you’re going to be altering your brain chemistry, you don’t want to play around.
Unfortunately, however, treatment resistance isn’t uncommon. Which means that patients might go through several antidepressant drugs, for several months at a time, before finding one that works for them. And even then, the benefits may not last.
Needless to say, any tool that can streamline this process is one that’s worth using. And pharmacogenomic testing—which evaluates a patient’s genes to predict responses to certain medications—definitely fits this bill.
In fact, research proves it: Symptom relief is greater among depressive patients treated according to test results, compared to patients whose doctors are just prescribing in the dark.
This latest study used the GeneSight test (which, by the way, is the same one I use), and compared the drug responses of over 1,000 patients. Ultimately, 26 percent of the tested patients saw improvements, versus only 20 percent of the non-tested patients. And 15 percent of the tested patients experienced full remission, versus only 10 percent of the non-tested patients.
This is a significant edge, on both counts. But the testing also revealed more than 200 patients on incompatible meds—in which doctors then switched to more appropriate treatments. Response and remission rates improved across the board in these cases, too.
As serious as a heart attack
Pharmacogenomic testing is by no means an exact science—yet. But it’s an excellent start.
As a clinician, blindly prescribing any medication when there may be a better alternative is a potentially dangerous waste of time. And this is especially true in the case of antidepressants, where patients wait months for drugs to take their full effect, only to find out that they aren’t really helping.
So while pharmacogenomic testing may not be standard procedure for most doctors treating patients with major depressive disorder, it certainly should be. With routine use, drug responses will be quicker and more complete. And that alone has the potential to save money and lives.
It’s easy to dismiss depression as a simple bad mood. But in reality, it’s one of the world’s most disabling illnesses. (And one of the most costly in the country, second only to heart disease.)
In a perfect world, no one would need antidepressants. But sadly, that’s not the world we live in. This testing, though, will put a dent in treatment resistance. And it’ll wipe out the hit-or-miss, trial-and-error approach to prescribing that most doctors rely on… at great personal cost to patients, I should add.
So if your doctor doesn’t offer it, I suggest asking why. And then finding one who does—before you step foot into the pharmacy again.
P.S. We’ve talked here before about how antidepressants may also disrupt sleep. And we all know how important a good night’s sleep is! My Perfect Sleep Protocol is an easy, drug-free approach to battling any sleep problems you may be facing—for any reason—and solving them for good. To learn more about this protocol or to enroll today, simply click here now!
“Genetic Testing May Help Identify Best Antidepressant.” Medscape Medical News, 06/06/2019. (medscape.com/viewarticle/914010)