Genetic testing

My T has mentioned genetic testing. I talk to my pdoc about it today. He said he normally recommends it for patients that have side effects to a lot of meds and have trouble tolerating a lot of the meds he prescribes. For me I tolerate just about everything but most meds work for two weeks and then stop. So he is wondering if I metabolize things too quickly.

Has anyone had this testing done?

You might post this on the medication thread for more responses. It has come up there a few times. Might also try searching it there. I've heard of it but never had it done.

I had it done. It was interesting. Didn't help me too much.

I have. It did help zeroing in on a medication and dosage. Of course, it didn't help when ex-psychiatrist Smaug decided to ignore the results and up a dosage she shouldn't have.

Your insurance probably will not cover it, but the company that did mine - Genesight - caps their fee at $330.

My PDoc suggested it a couple of years ago after I tried two meds for depression that did not work at all. I was reluctant at first, but the company she used had a sliding scale for the cost, and I went ahead and did it. Sure enough, the two drugs she started me on were in the "not very effective" category. So, we started on the list of recommended meds.

I was hopeful that at least one of those drugs would help me, but ultimately it turned that I have treatment resistant depression. If you can afford to get the test done, it may well be worth it just so you don't have to wait as long (assuming one works for you) to get the benefits. Good luck!

i had this done. it told us that i have fewer serotonin receptors in my brain. also i am the MET/MET COMT type (there is val/val , val/met, and met/met) which shows us my predisposition to psychosis. it also told us that my liver takes a long time to metabolize medications taken orally. it told us that the best medication for my psychosis is risperdal/invega

and all they did was swab my mouth

I just called Genesight and they said it would be $1750.

They may have changed their policy? I had mine done a year ago. But also my psychiatrist dealt with them over pricing - would yours do that?

I called again and this time was quoted the $330 amount. Apparently the first woman gave me a quote for NY or FL and she knew I didn't live in either of those states.

Thanks again for the info. I am glad I called back to check on it.

Crook32, is it depression meds that keep pooping out on you?

Yes and antipsychotics. They work for about two weeks and then stop.

I've had some done but not for medication related reasons. Genetic testing like 23andMe is all the rage, but the smart people are saying let's not get carried away. These tests show interesting info about predispositions, but they have to be used in conjunction with functional testing (not psychological testing, whole body testing) and other measures to have real value. Cant just look at genes.

As for drugs pooping out, based on my reading this is due to alterations in brain function caused by the drugs, e.g. in the case of SSRIs the body's own serotonin mechanisms become impaired by the presence of the drug, and thus over time there is a net decrease, and then you need more of the drug, or a new one, etc. In other words, the drugs are potentially exacerbating the problem by depleting the very substance that their whole model says is the cause of the problem in the first place (which has never been validated).

This is off-subject, but have you and your doctor considered bipolar? See here: Diagnosis | PsychEducation

Meds always pooped out on me and I often had significant side effects. Turns out it was abnormally presenting bipolar.

Yes the hospital this last time said bipolar. I am on lithium and Lamictal for that. But I have only been hypomanic once. My big problem is depression. So that is why we started up on the antidepressants again. I have been on so many meds I have lost count. Not sure if the genetic test will help but we are just going to give it a try. Can't hurt at this point.

So I read up a bit on these tests like Genesight. It sounds like they are basically checking which drugs your liver can metabolize effectively, based on genetic markers which predict problems with certain liver pathways that are commonly used by drugs.

But the tests ONLY give info about potential adverse effects related to liver metabolism. Adverse effects from other causes are not screened for.

Also these tests do not have anything to do with whether the drugs will "work", nor whether there will be withdrawal problems (and I can see patients being mislead to think this, which would make the tests a good Pharma marketing tool).

Also, it's ironic that docs are pushing these tests, but still cannot offer a test that shows why one would need a psychotropic drug in the first place, nor even what the drugs are doing to one's brain.

Genetic testing does also provide guidance on whether an individual's MTHFR Gene allows for proper conversion of folate, which can be very helpful in determining which types of anti-depressants are likely to have the potential to "work."

The testing will not provide definitive answers, but can still be of use, especially for patients who are not getting relief from a drug or two that have been tried already. Each person has to decide (probably with the aid of a psychiatrist) if the tests are worthwhile.

Just my 2 cents.

There is more to sorting out methylation cycle issues than just the MTHFR gene. If you look at it in isolation, and then supplement based on that, you can get into trouble.

However, in general, supplementing with Folate has the potential to correct some system-wide biochemical issues that could ultimately improve mood and brain function. Could be a MUCH better approach than doing drugs, which tend to throw biochemistry further out of whack. I would not trust a psychiatrist with this if my life depended on it. Functional Medicine docs all the way.