Personalized medicine: Improved mental health treatment guided by DNA

Personalized medicine: Improved mental health treatment guided by DNA

A growing body of evidence indicates that personalized medicine, or treatment guided by your DNA, improves mental health outcomes. A recent randomized clinical trial confirms that Pillcheck pharmacogenetics-guided medication therapy accelerates recovery for patients with depression and anxiety.

Finding the right depression treatment is often challenging

Only 30% of people suffering from anxiety and depression respond to the first antidepressant they try. If the first medication doesn’t help, the second or third often will. Yet many people who could benefit from an antidepressant never try one, often because of fears about them, experts say. Some individuals do not achieve symptom relief even after trying several types.

Established science of pharmacogenetics

In past years, clinical studies showed that genetic variations impact medication effectiveness. In fact, over 96% of people carry at least one genetic variation affecting drug response. Unfortunately, most health systems and medical practices are not yet designed to accommodate genetic insights in routine care. The Pillcheck service is built on the established science of pharmacogenetics (also called pharmacogenomics, or PGx) with clear evidence of cause and effect. With insights from PGx science, we can predict how specific patients will react to their medications.

New evidence supports personalized medicine for mental health

Pillcheck combines DNA analysis with an online medication review by expert pharmacists. Recently published results from an independent study using Pillcheck confirmed the impact of this prescribing approach to tailoring drug treatments for people struggling with mental health.

How does PGx testing affect outcomes for mental health conditions?

The study demonstrated that people suffering from anxiety and depression recovered faster with treatment informed by their genetics. This randomized controlled study followed more than 213 individuals filling prescriptions at several Shoppers Drug Mart stores in busy multi-ethnic neighbourhoods in Canada.

Method

For the randomized clinical trial NCT03591224, pharmacists asked patients taking medications for anxiety and depression if the current treatment was working well for them. Patients who reported side effects or poor mood were enrolled in the study.

The study assessed all participants for depression severity with standardized medical questionnaires.

All study participants provided a cheek swab for DNA analysis and were randomly assigned to the control group (“treatment as usual”) or the Pillcheck group.

A diagram illustrating the study design for control and Pillcheck test groups

Pharmacists provided standard medication reviews and recommendations on possible treatment options without seeing DNA test results in the control group. While in the Pillcheck group, pharmacists informed doctors why some medications did not work or caused side effects and provided their recommendations based on the patient’s drug PGx profile.

Prescribers were able to accept, decline, or disregard these recommendations. Patient-reported outcomes were assessed at regular intervals over six months. The study revealed that the outcomes for depression, anxiety and disability were almost two times greater in the Pillcheck group compared with the control group.

Pillcheck improves management of depression

The randomized controlled trial has shown that Pillcheck’s method of delivering genetic results is very effective: it enables pharmacists to identify drug therapy problems for individual patients and advise their physicians on personalized treatment options. Furthermore, doctors were more receptive to Pillcheck-based pharmacist recommendations, compared with standard pharmacist guidance without PGx.

What does it mean when patients are in the driver’s seat?

Pillcheck helps customers derive the full value of the investment in a genetic test by combining genetic insights with pharmacological expertise. Together, they allow for more effective medication selection and dosing. Among the best practices is informed consent and enabling individuals to control access to their genetic testing results. Pillcheck customers can elect to share their results with any healthcare practitioner they choose.

Since our DNA doesn’t change, Pillcheck is valid for life, and Pillcheck updates each report for new medications as guidelines expand. Using Pillcheck results repeatedly over time and bringing them to any doctor makes Pillcheck a medication passport for life. Customers often comment that Pillcheck gave both them and their doctor the confidence to change their medications without worry. Health outcomes improve when patients and physicians are on the same page and work together to understand the treatment and diagnostic options.

 

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About the author

Veronika Litinski

Veronika Litinski

MSc Medicinal Chemistry, MBA

Veronika is a medicinal chemist by training and first approached the health sector through cancer research at Lawrence Livermore Labs in Berkeley. Subsequently, she worked in capital markets and invested in innovative companies at GATX Capital in San Francisco. Veronika moved to Canada in 2004, where she joined the new MaRS innovation hub in Toronto. During their start-up phase, she was Director of the Venture Group, the ‘engine room’ of MaRS. Later she was Practice Lead for Health, working in one of the most complex and socially important sectors of our economy. Veronika also piloted the launch of Congniciti, a brain health company developed by Baycrest Hospital. She is currently the CEO of GeneYouIn and a leader in bringing precision medicine to health plans and individuals globally.