Genetic Test Could Revolutionize Depression Treatment

By Paul Fuhr 05/11/18

The test examines how patients’ DNA responds to specific antidepressants, which helps to shorten the road to recovery for many patients.

Image: 
woman preparing to take a pill

More than 16 million Americans suffer from major depression every year—and yet, there isn’t an efficient process to help physicians zero in on the medication that will work best for their patients.

Instead, antidepressants are given on a trial-and-error basis, with doctors largely hoping for the best when they prescribe a drug.

According to Time, however, a genetic test may be a game-changer when it comes to antidepressants.

The GeneSight genetic test examines how patients’ DNA responds to specific antidepressants, which helps avoid the frustration of going through multiple medications. It also helps to shorten the road to recovery for many people.

The study, presented at the American Psychiatric Association’s annual meeting, found that 50% of the people who use the test are likely to find success right out of the gate, while 30% are “more likely to respond to the drugs the test recommended, compared to people treated without the test.”

Time notes that there are over a dozen antidepressants available, including “newer serotonin- and norepinephrine-based medications that adjust levels of the brain’s mood chemicals.”

In fact, it’s that sheer number of choices that makes it difficult for doctors to get it right the first time. (Up to 40% of people fail to respond to their first antidepressant prescription, Time said.) The GeneSight test might help physicians hit the bullseye the first time, though, by examining 12 specific genes.

“These genes code for things such as enzymes that break down the key chemicals in the medications, as well as receptors that respond to brain chemicals that are targeted by the antidepressants, like serotonin,” Time reports. “In many cases, the way people break down drugs can affect whether they respond to these drugs or not.”

GeneSight categorizes antidepressants into three categories: green, yellow and red. Each category corresponds to how compatible a drug will be with a person’s genetic makeup. Drugs in the green category will likely have few or no side effects, while yellow drugs could have some side effects.

Red drugs “are the most useful category,” since it tells physicians what medications shouldn’t be prescribed. “Red medications should be avoided, since they simply are not right for the patient,” Dr. John Greden, the study’s lead investigator, told Time. “It’s as important to know what not to do [with prescriptions] as it is to know what to do.”

Still, some people criticize gene-based testing for antidepressant prescribing, claiming that there are too few people who have actually undergone the test to see if it’s effective. But while 1,200 people with moderate to severe depression have been tested, Dr. Greden says it’s more important to consider the amount of time GeneSight will potentially save physicians and patients.

“Data shows that the longer you’re in a state of depression, the more damage occurs,” he said. “Why do you want the guesswork when you can have some clues? We don’t have all the answers yet, but we have some powerful information to help guide treatment.” 

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.

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