Genetic Testing to Prescribe Medicine

Ok so my genetic test results... There are quite a few pages to this but I'll stick to basics.

In all sections there are three categories: Use as Directed, Use with Caution, and Use with increased caution and with more frequent monitoring. My copy is black and white but I believe they are color coded green, yellow, and red respectively.

First it provides Psychotropic results.

Here are the ADs they tested me against: Anafranil, Tofranil, Zoloft, Desyrel, Viibryd, Wellbutrin, Pristiq, Elavil, Celexa, Norpramin, Sinequan, Cymbalta, Lexapro, Prozac, Luvox, Remeron, Pamelor, Paxil, Emsam, Effexor.

zinco (no Fetzima). I was hoping it was on there. No Lamictal either but I've been hearing a lot about that one lately.

There are also Antipsychotics, which I do not take but here is a list of the drugs tested: Prolixin, Latuda, Invega, Geodon, Saphris, Seroquel, Navane, Abilify, Thorazine, Clozaril, Haldol, Fanapet, Zyprexa, Trilafon, Risperdal, Mellaril.

They provide additional information in the footnotes as to why the drug has been placed in its category. Some of them are: Increased risk of side effects, reduced efficiency, serum level may be too low (in smokers), serum level may be too low (higher doses may be required), difficult to predict dose adjustments due to conflicting variations in metabolism. I believe there are more that did not apply to me that were not included because i'm missing some numbers.

It also includes information on Analgestic results... pain killers. It includes the following drugs: Butrans, Duragesic, Avinza, Vicodin, Dolophine, Oxycontin, Tramadol, Codeine.

Out of all of the ADs I've already mentioned that only Wellbutrin and Pristiq were on the green list. Only 5 were on the yellow list. 13 were on the red list!! The only three ADs I've ever taken in the past were on the red list.

I know this post is long but I have another update on Pristiq. Mood is still good, no depression, slight anxiety but nothing too bad. Within the last 2 days I've been achy, particularly in my upper back/shoulders. My throat has also been bothering me (dry maybe). Fatigue has set in a bit. I am not sure if it's just me not getting enough sleep or if it's the medicine. I really hope its not the medicine because fatigue is why I got off Celexa. I have also noticed a bit of memory loss and confusion.. I'll get up to do something and completely forget what I was doing without being distracted (its not too bad though).

Plan is to stay on Pristiq for at least 4-6 weeks to give a proper trial. If it doesn't work out then I'll be trying Wellbutrin.

My to avoid list is huge as well. However, one on the green list seems to be helping: Geodon.

So, I have always considered myself an ambitious and motivated person. Well, after a little over a week on Pristiq I have NO motivation! None! I could sit on the couch all day playing video games or even be in bed sleeping all day and be perfectly content. Getting up to do anything seems like a pain.

Granted, I never want to do chores but I do them. I am always up for some exercise, doing the bills, or going out to be active BUT since Pristiq I've had no motivation to do any of it!

I really hope I break out of this soon because nothing is getting done. I am also noticing my appetite is back, even a bit on overdrive. So no exercise and extra food. I wear a fitness tracker and typically get 8000 - 13000 steps in on any given day... well since Pristiq it's only been 2000 - 3000!!! I am sure the weight will be pilling up on me quickly.

I slept for 15 hours both Saturday and Sunday! And this dry mouth is killing me... my TMJ is acting up now because of it.

I'm not sure if I can go another 5 weeks, at this rate I'll be 20lbs heavier by then!

Alright so I went for a short and slow walk today 1.2 miles at a very slow pace. I typically walk 2.5 miles a day this same route but today I couldn't even finish, I couldn't make it home. I had to be picked up and driven home.

I feel extremely weak and have sharp pains in the left side of my head. Has anybody experienced this? Is this normal? Should I be seeing a doctor?

I have never experienced that.

Fatigue is one of the listed side effects.

Do you have a blood pressure cuff where you can check your blood pressure?

Unfortunately I don't have one of those. I see my pdoc Thursday, so they'll take it then. I was just thrown off by my body being weak. I've been fatigued before, to the point where I have to sleep this was different, it's more like my body was weak and couldn't actually take additional steps if I tried.

Very odd. Did your head ache go away?

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I've gotten sharp pains before but from various tension type things. For example too much caffeine or withdrawal, celexa, tmj which I get from chemical or mental stress such as concentrating in front of a computer. Thinking it's possible it's a side effect of a side effect? Are the pains behind or near your ear?

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The pain is at the very top back side of my head on the left side. I have TMJ but that usually happens on the right side. My TMJ has been acting up quite a bit since starting pristiq. My head still has the shooting pains but they are more dull than sharp like before. It's possible the TMJ is getting worse but I usuaally get dizzy when my TMJ acts up and I haven't been dizzy yet.

So here I am nearly 2 weeks in and I'm still really tired, weak, and TMJ has flared up horribly!! Of all the side effects being tired is one I knew I would not tolerate but now I have 3 total I will not tolerate: teeth clenching/grinding, fatigue, and weight gain. Teeth clenching/grinding is a big deal because when my TMJ gets really bad I become extremely dizzy and have to take Dramamine which knocks me out and I can not work.

Since my TMJ is so bad I'm coughing up a storm, people think I'm dying because it's such a bad hacking cough. I don't think I'll be able to complete the month trial... my body is so worn down by the TMJ, fatigue, and weakness.

Although I must say the depression/panic attacks are still GONE! So Pristiq does it's job as far as that goes! Unfortunately, I can get the same from Celexa and it doesn't cause TMJ issues or body weakness, just the Fatigue and weight gain.

Now I have forgotten what you were taking before and why you stopped if it was working?

Doesn't say alot for the genetic testing as far as a low side effect profile. The side effects may go away if you stick it out but maybe they are just to intolerable.

Be interesting to hear what your pdoc says. I find the fatigue and weakness a very odd side effect for Pristiq but everyone is different.

Are you thinking of giving wellbutrin a try?

That's awful. I've never had tmj for more than a day at one time. I can't imagine weeks. Have you considered some message or maybe some time in a steam bath with eucalyptus? Not suggesting instead of anything but just as a way to help what you are going through.

I don't know if you are going to like me for this but you said the med helped almost immediately. But you went into this with a very positive outlook. That can be very healing all alone. So that would weigh on me a little bit considering your side effects.

Zinco,
The test is only a recommendation of what is less likely to cause problems. That in itself doesn't bother me but there should be no confusion about whether it is telling what you "should" take. It is not doing that at all.

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I was taking Celexa before but after 7 years it caused extreme fatigue (worse than what I have now), weight gain, and frequent urination. I stopped taking Celexa because of the extreme fatigue. I couldn't handle it anymore. I was on 80mg of Ritalin with Celexa at one point and was still tired. We finally realized Celexa was causing the tiredness. Switched to Lexapro, which did not make me tired but also did not help depression or anxiety very much, plus it had many other side effects.

Pdoc put me on Pristiq hoping it would be activating and help with depression/anxiety. However I told pdoc that I would not accept 2 side effects: fatigue and weight gain. I had no idea an AD could cause TMJ but this one has it in the list of side effects.

TMJ has recently been a huge issue for me, just got it about a year ago and it's been a huge struggle ever since to get a mouth guard/medicine to help me heal. I was out of work for awhile because when my TMJ is bad it makes me extremely dizzy.

So now here I am with the TMJ back and today I am dizzy again. The TMJ has been under control for about a month until now.

Yes, I am now thinking about trying Wellbutrin. I have to try something else, this is very painful.

I have tried hot baths with Epsom salt, taking magnesium, pain killers, cough drops, throat spray, using my mouth guard during the day (its meant for night use), lots of sleep, massage, etc...

Really trying to stick this one out but I really feel it wearing on me quickly. Day's half over at work and I'm exhausted.

The aromatherapy is also mentally soothing. I recommended it because tmj is caused by tension and only indirectly due to the med. if you like lavender the smell alone will calm you down which is what you want. It does more than that but that is a start. Chamomile tea will do the same thing but it is also a mild relaxant. The important thing is sip, sit or soak and appreciate the experience. Sounds corny but it will take your mind off of the pain.

Those things you listed don't smell or taste as nice

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Sounds nice. I should definitely give it a try!

Saw pdoc today and I am going to switch to Wellbutrin as of tomorrow. Starting on generic Bupropion HCL SR 100mg as of tomorrow. Hopefully this will be the one for me. It is used for all the side effects I typically have with an AD... fatigue and weight issues and it doesn't list clenching or grinding as a side effect. I am optimistic. As of now I do still think the genetic testing is helpful but I also know that in general I am sensitive to medicines and typically have side effects.

Good luck

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most of the meds that work on seratonin in a certain way, I don't know how, cause bruxism, which is teeth clenching/ grinding which leads to tmj. I have never had tmj before until I tried lexapro, Zoloft did it to me as well. I'm on Wellbutrin though with no problems and Haldol. I have schizoaffective and the haldol about kills me, though its my miracle drug, so we were looking for a seratonin based antidepressant to help raise those levels and get my life back without spinning me into a bipolar cycling like so many of the antidepressants do. It is a balancing act. I know I did some sort of cheek swab that my pdoc took and it says i'm a rapid metabolizer of almost all the antipsychotics. Thus, I've tried them, they failed and I ended up on haldol. Best of luck to you. Watch out for bruxism with the antidepressants because that is what is flaring up your tmj. Horrible!

Yeah, the bruxism is extremely bad with Pristiq unfortunately. It might be that after 6 weeks or so it may have cleared up but it was a bit too much to bare. I am trying Wellbutrin name brand now to see if my genetic test is of any use. We'll see how it goes.

Thought you ditched the Wellbutrin and went with 5 HTP? Is there any difference between the name brand and generic? There is not supposed to be but who knows with the generic labs and where your pharmacy might be getting them.

The Fetzima is getting me a little worried. Very wired and kind of manic. Can't relax or shut my mind off. That is why I am posting so much on here. Sitting here typing calms me for some reason. I guess I should do it in a private journal.

I don't know if there is a lower dose of Fetzima or not. Maybe I should lower my Fetzima and raise Lamictal. I never look up the meds once I decide to go on them. It is just wait and see but maybe I should look up Fetzima. It is pretty new though. So crap I don't know what to do at the moment. Ain't meds a *****.

Yeah I tried the 5-HTP and it was horrible! It made me sweat, was hot all the time, had very weird and odd dreams, couldn't sleep well, and my heart was racing a bit... That was worse than any of the ADs I've ever taken.

I figured id give the name brand a shot to see if it was a filler component of the generic but after trying it today I can see it's the same at least for me, got the same rash/itching... So Wellbutrin is out for sure. Not sure what we will try next... I'll be seeing the pdoc tomorrow.

So maybe there is something here after all. I am on Viibryd 5mg, which was yellow on my genetic test and it seems to work well so far. I've been informed by my doc that these test are helpful in that they tell you which meds you metabolize best but they do not tell you exactly how the med will work. Well I knew that, but I was about to give up on it but figured it's a good baseline to follow so we went with the Viibryd.

Pdoc also mentioned brain scans that can be done to determine if you're likely to do well on a particular AD I guess they take scans of your brain then compare them to other depressives who have had success with particular medicine. Then they prescribe the medicine based on the person who has similar brain activity as you. Even in this case it's a toss up as to whether or not the med will work for you. But at least you can have some sort of science behind your choice.

Before you shell out money for the brain scan do yourself a favor and do some research. Your doc was right on with the test but there isn't a lot of good evidence for the scans. They have acknowledged that the people they used for research were on meds. We do know meds modify your brain. So they do the scan and that's often what they are seeing. Then assuming they are comparing a non medicated person it is a guess at best. Not really ready for prime time. The saliva test seems to have more validity IMO. I actually read an interview with a doc who admitted he uses the scans to make patients feel better and are therefore more compliant about taking the meds. Don't believe me though. I'd encourage you to do your own research and come to your own conclusions.

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Thanks for the caution but I'm not getting a brain scan. I was just mentioning something my pdoc said. I'm done getting tested, the genetic test was enough for me. I am glad I did it since it gave me a place to start. The Viibryd is actually working well so far. I hope it will continue to work well and I'll be done with worrying about it for awhile, hopefully a long while!