Last Monday we looked at antidepressants and what they do, however with there being so many types out on the market surely there must be an easier way other than trial and error to work out what one will work best for you.
Genetic testing is slowly becoming more common in the medical world. We can now work out what antibiotic will work best for an infection especially one that appears antibiotic resistant, what cancer treatment will work the best with the least amount of side affects and what diseases our bodies have a higher risk of getting (such as specific types of cancer).
It makes sense that genetic testing will soon start to play a role in treating mental illnesses. What if a test could tell you the exact medication to take and take out the guess work of trying multiple antidepressants (each with their own unique side effects) until you found the one that works? Or if a test could tell you if you were at a higher chance of getting a mental illness, so you knew the signs and could get on top of it now? Or even a personalised medication made up for your exact mental illness regarding your genetic makeup?
While the last one is a long while away, there are tests that are slowly getting developed to helped with the other points. Currently on the market is a blood test that is used in determining how quickly you metabolise certain medications, so that you can make sure you are on the correct dose. This test takes around 3 weeks to get results and does cost out of pocket. However, more and more mental health professionals are recommending it as it allows them to treat their patients more accurately. What might be considered a high dose of medication for the average person might be a normal dose for someone who metabolises it quickly or a low dose might be the right dose for someone who metabolises it slowly. It also allows your doctor to prescribe you the best medication that will work for you with the lowest amount of side effects.
In the US some companies are offering blood tests that claim to be able to identify what antidepressant will work best for you. They claim to save people time, money, and heartache by taking the guess work out of trying to figure out what antidepressant will work best. However, there is not enough evidence to know just how efficient they are and if they are worth the cost. In some cases while they have identified a specific medication that won’t work and was backed up with the patient previously trying it to no success the medications that are identified as beneficial had no impact despite the test saying they should. Which is why many doctors are hesitant to recommend these tests as they believe that the science isn’t there yet. Though hopefully as more work is being done with these tests, they will soon be more accurate and offered in other countries.
Genetic testing is becoming more and more common in helping people recognise the chances of developing illnesses some of which could have devastating impacts and being able to get on top of treating them sooner. However, the idea of genetic testing for mental illness is controversial as like with all testing it’s not 100% accurate and it can’t predict how severe the mental illnesses can be. Also that there is no preventative treatment for mental illness even with the results nothing could be done to stop the mental illness from happening. However, doctors could monitor those who were at higher risk of a particular mental illness and get on top of them sooner. There are also the issues about who should be eligible for these tests and how the results can affect people. For example, can someone under the age of the 18 be tested and how will the results impact relationships with their parents and peers.
These tests are at the beginning stages of development as there isn’t a specific gene variant identified that causes mental illness. There’s also the issue that mental illnesses can be caused by a variety of things not just genetics such as environmental factors which wouldn’t show up on a genetic test.
There has been talk that genetic testing could help unlock different types of psychiatric treatment, offering those with mental illnesses other alternatives that could work specifically for them. But at this point in time this is just speculation and it’s unsure what the treatments could be.
While there is a want for genetic testing to determine the chances of getting a mental illness there is a lot of to be thought about including ethics and who would have access to the testing such as those under 18 or those who have no family history regarding mental illness. There is also the question about who could have access to the results and what they could be used for. While genetic testing is helpful, there is the thought that at times it can do more harm than good.
There is no doubt that genetic testing will play a part in the future of mental health treatment, but there is the question of how much of a part it should play and how much weight should be put on the results. When it comes to treating mental illness, we need to take a holistic approach looking at all the factors and that everyone is different. Just because a genetic test says you are processing a medication normally doesn’t mean you shouldn’t go on a higher dose if your body needs it. Brain chemistry is complex and there is sometimes no overlap with how fast someone processes or metabolises a drug with how well it works. Ideally a doctor should be able to see use these results as guidelines for treatments while also looking at other factors. It’s not to say don’t do these tests just realise they won’t give you all the answers and remember that treating a mental illness can be complex at the best of times.
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Pharmacogenomic testing and antidepressant response: problems and promises On the Marketing and Use of Pharmacogenetic Tests for Psychiatric Treatment | Depressive Disorders DNA tests that cost as much as $750 claim to tell you which antidepressant is best for you, but scientists say they’re not worth the money RACGP - Pharmacogenomics in general practice