Medication Review


Pharmacogentic (PGx) testing is becoming more of a hot topic as providers from every specialty try to figure out how to treat their patients more efficiently and effectively. PGx testing uses a patient’s own DNA to help guide which medications will work, should be used with caution and those that should be avoided. These insights help guide providers to treat the patient with the most effective treatment for them the first time, thus eliminating the costly, and sometimes dangerous, trial and error approach to finding the medication that best
works for the patient.

Mental Health PGx – Why is this important?

Antidepressants are the 3 rd most commonly prescribed drug type and anti-anxiety medications account for $42 Billion in annual health care costs in the United States. 1/3 of patients suffering from anxiety actually receive treatment, and from this group, only 60% of those patients respond to treatment.

It is staggering that One in Eleven US adults report the use of an antidepressant medication in the last 30 days. As well, depression is an independent risk factor for coronary artery disease and sudden cardiac death, which leads to a 7-11-year reduction in life expectancy, which is similar to lifetime smokers. 70-80% of prescriptions for psychiatric medications are not written by Mental Health specialists, but by Family Practitioners, PCPs, Internal Medicine Providers and OB/GYNs.

Trial and error in these patients can cause unwanted and detrimental effects when initiating or changing medications. Many mental health medications need to be tapered up or down when dosing, so knowing which medications work in a specific patient has enormous validity in the practice setting. Trial and error can be very costly for the patient as well due to multiple copays at the pharmacy, multiple provider visits and potential ER visits due to adverse effects.

Providers can be provided with the knowledge of their patient’s genetic status to help predict what response they would have to a new medication, or a medication they are already on. This knowledge has substantial benefits as more than half of the drugs that are most commonly involved with adverse drug reactions are metabolized by the polymorphic enzymes.

Studies have been done regarding the effectiveness of PGx in the mental health population. A study by Bradley, et al showed that in Moderate to Severe Depression, patients achieving response AND remission was higher in the PGx group compared to the normal treatment group.