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Pharmacogenetic Testing

Many people who live with mood disorders have made the choice to add medications to their treatment plans. However, it can be difficult for psychiatrists and primary care doctors to pinpoint which prescriptions will provide reliable relief without unwanted side effects. Studies show that many people try different medications over periods of 5 to 10 years, searching for the right solution.

Some doctors have used pharmacogenetic testing – PGx testing for short – to provide insights that can help with treatment planning. These tests have garnered attention in news media and online conversations, so you may have wondered how they work and why you might want to consider this emerging technology.

 

A closer look at pharmacogenetic tests

Let’s break this long and difficult-to-pronounce word into two parts. “Pharma” is a prefix used to describe the science of pharmacology and the study of drugs. “Genetic” refers to the genetic makeup of an individual or group of people. The Mayo Clinic defines PGx testing as the study of how your genes affect your body’s response to different medications.

Our genes influence the chemical process known as metabolism, which in this case means the way your body breaks down medications and nutritional supplements. Taking a look at your individual genetic makeup can reveal how your body is likely to utilize a particular drug. For example, if your metabolism tends to break down some medications quickly, a standard dose might not work for you. But if you tend to break down some medications more slowly, this may lead to troublesome side effects.

How this form of testing works

The first step is for a health care professional to submit an order for a PGx test. Next, a small sample of your DNA is usually obtained by swabbing the inside of your cheek. Your sample will be sent to a testing lab for analysis, and the results are returned to the health care professional who ordered your test.

Your doctor will review the test results with you and discuss how your genetic makeup may inform prescribing decisions. Along with PGx test results, your age, gender, other medical conditions, and any other drugs you take may also be factors in your doctor’s recommendations about possible treatments.

Once you and your doctor come up with your overall treatment plan, including medication, you should be able to spend less time in your doctor’s office, less time struggling with work responsibilities, and more time living the life that you want.

 

Tips for talking with your doctor

You may feel unsure about raising the topic of PGx testing with your psychiatrists or primary care doctor. Here are some suggestions that can help you prepare for your conversation.

  • Be honest in describing how you feel about your current treatment plan. Be clear about what you think is working well, and what aspects of your treatment, including side effects, you’d like to see improved.
  • Bring a complete list of your current and previous prescriptions and over-the-counter medications, including supplements for mental health and any other conditions.
  • Offer the names and contact information of other health care professionals that you see currently or have seen in the past.
  • Bring a family member or a close friend to your doctor’s appointment. This should be someone who can create a good environment for your conversation, help you ask clarifying questions during the appointment, and take notes for you to review later.

Because PGx testing is a relatively new offering, some doctors may be unfamiliar with it. If you are interested in pursuing this kind of testing, you may find that getting a second opinion is helpful.

Cost and privacy issues

Two of the most common questions about PGx testing are about costs and privacy. These concerns are quite natural, given the need for confidentiality of medical records and the high cost of newer medical technologies.

Cost. In October 2019, the nation’s largest private insurance company, UnitedHealthcare, began covering pharmacogenetic testing. Some experts predict that more private insurers will follow UnitedHealthcare’s lead. And some Medicare plans have started covering pharmacogenetic testing.

We recommend you check with your insurance company to determine what out-of-pocket costs might be your responsibility. Also, in some cases, manufacturers will place a limit of a few hundred dollars on your out-of-pocket responsibility for the test.

Privacy. While each company may have different policies, leading testing organizations are fully committed your privacy. For example, a unique ID may be assigned to your sample when it is received, so that throughout the testing process, your personal information is not associated with it.

Read more about PGx testing

Here are other resources that can offer additional perspectives on PGx testing.