In the previous blog post, I spoke about certain obstacles that pharmacogenetics testing will have to face in its implementation. Today, lets talk about what pharmacogenetics has accomplished currently in Psychiatry. In Part One, I mentioned that fully personalized psychiatry is still in the future, but that isn’t to say that pharmacogenetics in Psychiatry isn’t used effectively today. Dr.Melissa DelBello brought a wonderful example just how successful pharmacogenetics is working in Psychiatry :
“One example that rises quite frequently is in the management of patients who require antipsychotic medicaitons, particularly aripiprazole and risperidone. Consider the common situation of a 13-year-old boy diagnosed with ADHD and bipolar disorder. The treatment plan included psychostimulants and a second-generation antipsychotic, in this case, aripipirazole. The standard starting dose is 5mg orally daily. After a week on aripiprazole, the boy experienced terrible nausea, akathisia, and sedation. On the other hand, his manic symptoms improved. Of course, when he refuses to take the medication because of the adverse effects, the manic symptoms return. Pharmacogenetics testing eventually revealed that the boy was a slow CYP2D6 metabolizer. The patient eventually agreed to take the medication at a lower dose of 2.5 mg. At the lower dose, the boy’s symptoms were well managed by the medication and it was well tolerated.” Dr. DelBello goes on to inform that Pharmacogenetic testing is working really well for antidepressants, stimulants, mood stabilizers, and anxiolytics.
One of the pros that comes with pharmacogenetic testing is that we, as the patients, are able to understand what changes are being made to our medications and why. This aspect is especially important for psychiatry patients who have long since been through the trial-and-error process of finding their correct medication.
h/t pharma in psychiatry