This is especially important for medications used for depression, anxiety, mood disorders and other mental health concerns.

The smart approach is called targeted or personalized prescribing. The question is how does a doctor get the information to do the targeting or personalized prescribing.

The information should be based on the patient’s genes. It is an analysis of his/her genes that provides this information. A saliva test is all that is required. The report provided by a credible genetics lab, such as Inagene in Toronto or Personalized Prescribing, contains all the information that the doctor needs to do personalized prescribing.

The report from the genetics lab tells the doctors which medications to use and which to avoid. It also tells the doctor about dosing the medications. And which other medications of substances such as cannabis will interfere with the prescribed medication.

Everyone metabolizes medications in different ways. Some patients are rapid metabolizers and require higher doses. Some patients are slow metabolizers and require lower doses.

The tests are easy to organize. Go to the lab’s web site. Register. Get a kit. Collect a saliva specimen. Submit the specimen by mail. And the result will be a comprehensive analysis of your genes as they relate to medications. Send a copy of the report to your doctor.

Case Study:

Betsy was 33 years of age. She had gotten increasing sad over the last year or so. She was also anxious. She went to her family doctor. The family doctor prescribed an antidepressant that worked for a while but then stopped working. The family doctor wanted to switch Betsy to another antidepressant. She took the new antidepressant and stopped the first antidepressant cold turkey. That was a mistake. It should have been tapered slowly. This resulted in Betsy becoming ill as she withdrew from the first antidepressant and got a full dose of the second antidepressant.

Betsy’s enlightened friend who is also a doctor suggested the inagene test. The results showed that Betsy had a number of gene mutations including the CYP2C19 gene variant. The inagene report suggested that the doctor use another antidepressant. And if this specific antidepressant was used that the doctor should consider a 50% dose reduction.

Her family doctor was not interested in the genetics report. However, Betsy had been referred to a young psychiatrist who was totally up to date on the science and understood how to interpret the genetics report, how to select the correct antidepressant and how to dose the medication based on the patient’s genetic report.

Summary:

Prescribing medications is usually an experiment that might fail. Now with genetic testing of patients, doctors can have the information that helps them and the patients by helping with the selection of the right medication and then by helping with the decision about dosing.

The key for patients is to find a doctor who understands or is willing to learn how to use personalized or targeted prescribing based on the patient’s own genetic information.

Keep well. Be safe.

Raymond Rupert, patient advocate and healthcare consultant.

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The problem is that each prescription is a chemistry experiment. No one can predict how a patient with depression, anxiety or a bipolar mood disorder will respond to the medications. Each patient is different. Each patient reacts differently to their medications.

It is time to end the chemistry experiment.

Now a simple genetic test using some cells from inside your mouth can be used to determine how a patient will respond to mental health medications.

The results of the genetic analysis, called pharmacogenomics, provides great intelligence about how to treat the patient.

The results of the tests such as inagene or one ome will tell the prescribing doctor what to avoid and what to use. It is simple.

And the test results will tell the prescribing doctor who is likely to become addicted to opioids and which type of cannabis to use for therapeutic reasons.

So we can stop the chemistry experiments and personalize the use of mental health medications with the use of a simple and modestly priced genetic test.

Tell your doctor about this test and that you don’t want to be involved in a chemistry experiment. Tell your doctor that you want personalized medicine. Or call RCM Health Consultancy and we will arrange for the genetic testing. 647 350 5500.

Raymond Rupert patient advocate and healthcare consultant.

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These tests are different from genetic tests for inherited cancer risk. The genetic tests for inherited cancer risk are known as germline profiling of the whole person.

As cells become cancerous, they develop many gene mutations that cause abnormal growth.

These gene changes, which occur after you are born and throughout your life—are known as acquired or “somatic” mutations. 

Acquired or somatic mutations are different than inherited mutations, which are passed on from parent to child and are present at birth in every cell. 

The findings of a study published in Jama Online suggested that germline analysis (inherited genes producing cancer risk) following tumor sequencing will produce findings that may impact patient care by influencing systemic therapy choices, surgical decisions, additional cancer screening, and genetic counseling in families.

A recent case which we managed at RCM Health Consultancy involved a review of the client’s genes to understand how this client would metabolize chemotherapy agents. By looking at the genes, the consultant was able to inform the client about dosing of appropriate chemotherapy agents. This was very valuable for this client and his/her oncologists. This field of expertise is called oncogenomics.

Current guidelines and tumor testing approaches appear to provide evidence of many of these germline findings, reinforcing the use of both expanded germline follow-up testing as well as germline analysis independent of tumor sequencing in appropriate patients.

The combination of germline testing ( for inherited cancer risk) and the analysis of cancer DNA ( through molecular profiling) is a powerful set of tools for the cancer patient.

Raymond Rupert patient advocate and healthcare consultant.

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