How genetic testing could help people find the right antidepressant

Adam Barnes
·2 min read
1

Story at a glance

  • Researchers used pharmacogenomic testing to look for drug-gene interactions that could affect the way a patient reacts to an antidepressant.

  • “The genes we tested don’t actually relate to depression. They relate to how a person metabolizes the drugs once they’re in the body. Some of these genes will cause the medications to metabolize much faster than normal,” the study’s lead author said.

  • “Others will cause the drugs to metabolize much slower than normal, which means you’ll end up with a lot of medication in your body,” he added.

Genetic testing could help health care providers prescribe antidepressants that have fewer negative effects on their patients, according to a study published Tuesday from the Department of Veterans Affairs.

A 24-week study found the group that underwent genetic testing, compared to the control group, showed a decrease in symptoms, peaking at 12 weeks. The team used pharmacogenomic testing to look for drug-gene interactions that could affect the way a patient reacts to the antidepressant.

“The genes we tested don’t actually relate to depression. They relate to how a person metabolizes the drugs once they’re in the body. Some of these genes will cause the medications to metabolize much faster than normal,” said David Oslin, the study’s lead author and director of VA’s VISN 4 Mental Illness, Research, Education, and Clinical Center (MIRECC).

“Others will cause the drugs to metabolize much slower than normal, which means you’ll end up with a lot of medication in your body.”

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Each of the 2,000 patients from 22 VA facilities who were enrolled in the study suffered from a major depressive condition and were either beginning or switching medications. Half of the patients received the testing while the others were offered usual care.

The team found that providers moved away from prescribing medications with significant or moderate interactions within the testing group. Approximately 59 percent of patients in the testing group received medication with no predicted interaction.

Patient interviews from the 12-week mark of the study showed that depression remission, depression response, and symptom improvement were better among patients in the testing group.

“It’s important to realize that the test is not telling you whether the patient is going to respond to the treatment or not,” Oslin added.

“It’s telling you something about how the patient metabolizes the medication. So, it’s not telling me that this is a good medicine for the patient. It’s telling me not to prescribe this medicine, or perhaps to adjust the dosing, because the patient doesn’t metabolize it well.”

The study’s results were published in the Journal of the American Medical Association.

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