Note: I wrote this back in 2014 to share to some support groups. Posting it here. Some info is outdated. There are newer more comprehensive tests available & costs have changed but otherwise it’s accurate. I will update this post when I have spoons with newer info & a longer story of what happened next with my doctors trying meds.
I’ve been researching the topic of issues with medications since I was tried on and taken off four different meds recently due to bad side effects including ER visits for things like tremors and fainting with very low doses of SSRIs.
My doc and I have discussed that there may be something up with my drug metabolism since I’m reacting badly to very low doses of common meds. He mentioned that there isn’t an easy and inexpensive way to test drug metabolism to help in figuring out what to prescribe.
Not to be deterred, I started looking at tests available out there. One test I’ve found is pharmacogenomic drug metabolism testing. The FDA has guidelines for prescribing meds based on the results of these tests so its decently well accepted. Yet not frequently used by many psychiatrists. One reason is probably cost and another may be how well docs keep up with new developments. Places like the Mayo Clinic seem to use these quite a bit in their mental health practice.
Anyway, I thought I’d share this since some of you may be in the same boat as I am with regards to drug reactions.
Pharmacogenomic tests look at certain genes in your DNA to determine how you’ll respond to certain psychiatric meds. The usual doses are based on average safe doses but there is a lot of variability between people. So this is essentially personalized medicine.
Here is the list of drugs for which the FDA has approved the linkage to certain genetic info: http://www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm
Here is general info on the testing:
I also called testing companies to ask for costs in case insurance doesn’t cover. Assurex Health which does the GeneSight test used by the MayoClinic takes care of working with insurance to get it covered. The test cost is $3800. But if insurance doesn’t cover it, they offer financial assistance for people with household incomes less than $150000. So the out of pocket cost ends up being between $25 to $200 depending on income. Which is cheaper than my copay for ER visits!
The test still needs to be ordered by a doctor & my psychiatrist wasn’t being helpful with this. I eventually found a new psychiatrist who ordered the GenoMind test which is very similar to Genesight. In my case insurance didn’t cover it but Genomind didn’t bill me so it ended up being free.
We found out that a serotonin transporter gene variant I have means I react badly to SSRIs in general & shouldn’t be prescribed them.
Hope this is helpful to others who’re dealing with the drug reactions and the not fun trial and error method of picking meds.