Can Genetic Testing Predict A Patient’s Response To Medications?
A question we hear, that comes up often in our Austin clinic. Can Genetic Testing Predict A Patient’s Response Medications? Another question comes up too. Is genetic testing better for a company like Ancestry.com or 23&Me and their bottom lines than your emotional well being? Let dig into this a bit further.
At Pondworks, Austin we strive to provide a balance between new technologies and good old fashioned care. Sometimes this can be hard work with all the advertisements and proposed new treatments. There was one recent product to show up at our doorstep. It came in the form of gene testing to guide the choice of psychiatric medication. After hearing the proposed benefits, I was surprised at the level of benefit proposed and also the cost associated with testing. Could I be missing some large body of research that gave substance to this level of confidence?
A Balance Between New Care And Proven Care
As part of the Pondworks mission to provide this balance between “new care” and the “proven care” I often find myself spending time outside of clinical care researching claims such as this. After a review of large psychiatric texts and journals, I was unable to gain confidence in companies selling genetic testing for making choices regarding psychiatric medications. Do we feel that maybe in the decade-plus future these claims can be made with confidence? I concluded now is not the time to utilize these services.
I’d like to say the story was simple and ended there, but it has been an ongoing concern. Patients often come to me with tests in hand and understandably have an expectation to be fixed by the suggested medication. It takes time to build trust with them that the report they bring in may not deliver what they expect. And to not lose their hope about feeling better in the process. Sometimes that time is precious to starting a successful treatment relationship, and I worry that at times that their care is adversely affected.
True to our Pondworks mission, we have continued to have this dialogue with patients. There are times though, I have to admit I found it frustrating. I thought that there should be a larger organization that could help. That organization could lend their voice to ours in establishing the value of genetic testing of this sort.
A Warning From The FDA Regarding Genetic Testing
I was delighted when the FDA issued a safety communication about this subject titled,
“The FDA Warns Against the Use of Many Genetic Tests with Unapproved Claims to Predict Patient Response to Specific Medications: FDA Safety Communication” (https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm624725.htm). In addition, it has also issued a warning letter to Inova, a company operating in this area. Here is what the FDA had to say about depression and anxiety medications and genetic testing:
“… the FDA is aware of genetic tests that claim results can be used to help physicians identify which antidepressant medication would have increased effectiveness or side effects compared to other antidepressant medications…..
……However, the relationship between DNA variations and the effectiveness of antidepressant medication has never been established.”
Austins High-Quality Mental Healthcare Provider
The safety advisory audience includes both providers and patients. If you are included, I encourage you to check out the advisory and consider the suggestions the FDA offers. It will fit with what you will hear from our clinic and possibly your Pondworks provider as we look to provide balanced high-quality mental healthcare.