Wouldn’t it be convenient if a doctor could look at your DNA and make a recommendation about which medications would be most effective for you? Some companies believe that they have found the perfect algorithm to bring patients exactly that. However, recent criticisms from scientists are beginning to challenge the legitimacy of these multi-hundred dollar tests.
Since mental health varies from patient to patient, the search for the perfect cocktail of antidepressants, mood stabilizers, antipsychotics, sleep drugs and more can be challenging for the psychiatrist and unhealthy for the patient. A process that would cut out the in between trial-and-error would be any mental health professional or patient’s dream service.
Genomind and Genesight are two types of genetic testing that produce predictions about how an individual’s mind would interact and respond with different medications. However, that is all that these tests can offer at the moment: a prediction. Following the test, patients receive a list of medications with green, red, or orange markings that predict their success. These tests are too new to test their actual success rates in terms of health, but Genomind conducted a study about its cost-effectiveness and found that patients who took this test ended up spending an average of $2,000 less on healthcare in the 6 months following the test.
While cost-effectiveness should be a factor considered when treating patients, the most important motivator for healthcare always has been and always should be the good health outcome. These genetic tests, in conjunction with a comprehensive assessment and clinical picture, can be useful as a template and guidelines for prescribing. Right now, these tests cannot tell psychiatrists which drugs will produce the most positive results with the fewest side effects for patients, but they do help clarify the role of liver enzymes (Cytochrome P450) in predicting the rate of fast or slow metabolizers, which in turn helps the clinician select the correct dosage of the medicine being prescribed.
As our biomedical technology and genetic research advances, genetic testing possibilities will also progress. In the meantime, we, as psychiatrists, can rely on existing testing to guide and must continue to treat the full patient – body, mind, and soul – through a variety of methods that extend beyond just medicine.