Precision Medicine with Gene Testing
An emerging and promising tool in psychiatry is pharmacogenetic testing. This is not a first-line treatment but may be indicated for certain patients. GeneSight testing can help us understand how a patient's genetics and metabolism influence how they may respond to a particular medication or dose. This testing provides information about the pharmacodynamic genes which may indicate the likelihood of a positive response or risk of side effects with certain medications.
GeneSight testing also gives information on pharmacokinetic genes which provide a deeper understanding of how a patient's body metabolizes medications. This can help with the optimization and precision of dosing.
One area of particular interest to us is testing for a mutation in the MTHFR gene. MTHFR is an enzyme required to convert folic acid into the active form called L-methylfolate. This plays a critical role in making neurotransmitters such as serotonin, dopamine and norepinephrine. Patients with this mutation may need a different approach to best treat their mental health problems.