What You Need to Know about Pharmacogenomics

Wednesday, July 5, 2017
Dr. Michael V. Genovese

With the advancement of medicine today and the multitude of available options, psychiatrists are faced with several ongoing challenges when it comes to creating an appropriate course of action for individualized treatment. Pharmacogenomics is the study of how a person’s individual DNA affects his or her response to medications and a scientific method of evaluating which medications a patient is likely to tolerate. The primary role of pharmacogenomics is to develop rational means to optimize drug therapy, with respect to the patient’s genotype, to ensure maximum efficacy with minimal adverse effects.

Many factors are considered when selecting and administering an appropriate medication such as efficacy, side effect profile, compliance, cost, family history, and the patient’s previous medication trial. These factors rely heavily on the patient report and other subjective factors. There are few objective, evidence based biomarkers for medication selection and dosing in psychiatry. Approximately 50% of patients do not respond to their initial medication treatment and up to 30% discontinue in response to intolerable side effects. Additionally, nearly 70% of patients are non-adherent to their prescribed medication schedule, with adverse reactions representing the most common cause. The statistics reveal the need for an individualized approach to patient care, along with a specific treatment plan to meet the patient’s needs.

Pharmacogenomics provides an evidence-based approach to improving customized treatment outcomes. This personalized approach to medicine is safe and easy to accomplish. It minimizes patient frustration associated with a trial-and-error approach to pharmacology. The simple act of testing a patient involves collecting cells from the inside of the cheek with a cotton swab. The cells are subsequently sent to a lab and results are generally available within a week. A comprehensive report provides patient-specific information regarding the genes that code for enzymes, which are responsible for metabolizing medication and regulating its activity at the neuron.

Pharmacogenomics is a cutting-edge approach to behavioral health medicine, specifically in the treatment of addiction, and a breakthrough in the provision of comprehensive and uniquely designed treatment plans. Information provided within the report is invaluable to a physician, patient, and clinical team. The data is not dispositive, nor does it dictate that a certain medication must be administered. Rather, it provides information about how the body breaks down specific medications, the likelihood of side effects, and the potential for efficacy based upon the patient’s DNA. Therefore, with more accuracy, we can predict benefit, while simultaneously validating previous suboptimal attempts. We can demonstrate that a patient’s inability to tolerate a prescribed medication was not weakness but genetic predisposition. With the support of pharmacogenomics data, physicians can more accurately dose a medication and/or confidently select an alternative. A “best guess” is no longer necessary. We are given the opportunity to blend the art and science of medicine more successfully than we ever could in the past.

Research indicates that patients experience up to 70% greater improvement when pharmacogenomics testing was implemented into their treatment. They appreciate the personalized data and are much more responsive to their customized treatment plans. Well-informed patients express a higher-degree of confidence when participating in this specific treatment modality and, as a result, are better equipped to experience success in the healing process.

North Bay Recovery Center has been dedicated to helping individuals on their path to wellness and recovery. With the implementation of pharmacogenomics, we can see the benefits that have come from merging medicine and therapy, in a way that benefits the treatment of our patients. We are excited to offer this cutting-edge, and effective medical intervention.