Anna was diagnosed with post-partum depression after the birth of her first child. The medications she was prescribed did not work for her. Pillcheck helped her doctor understand why…

Anna was diagnosed with post-partum depression after the birth of her first child. She was fatigued, experienced mood swings and suffered from sleep deprivation. The medications she was initially prescribed did not alleviate her symptoms.

Anna was first treated with Citalopram, a commonly used antidepressant in a class of drugs known as ‘serotonin reuptake inhibitors’. Standard and high doses had no effect on her symptoms and there was no improvement in her condition. Her doctor decided to switch her medication to Amitriptyline, which belongs to another class of drugs called ‘tricyclic antidepressants’. Unfortunately, Amitriptyline caused further sleep disruption, and Anna eventually stopped taking the medication. She was told by her doctor that she needed to wait for this drug to clear out of her system before trying another medication. Anna was frustrated; during this time, she heard about Pillcheck and decided to order the test.

How Pillcheck Helped

The test results revealed that Anna carries two copies of the CYP2C19*17 variant, which is an allele (form of a gene) that results in ultrafast metabolism of certain drugs. This is why she did not respond to normal doses of Citalopram and Amitriptyline – the drugs were cleared too quickly from her circulation by a hyperactive form of CYP2C19.

People who are ultrafast metabolizers of Amitriptyline, Citalopram and other medications that are processed by this liver enzyme only experience short-term relief, and there is an increased risk of mood swings.

Acting on this new information, Anna’s doctor recommended an alternative medication that is NOT metabolized by the CYP2C19 enzyme. Finally on the right drug, Anna’s symptoms disappeared and she was back to being her normal self again.


jeff_pain JEFF’S STORY

Even though Jeff was taking high doses of painkillers after orthopedic surgery, his pain was not well managed – until a Pillcheck test.

Jeff sustained significant injuries to his right foot following a motorcycle accident and needed to take high doses of different pain medications to manage the excruciating pain. At the hospital, Jeff was treated with Morphine following orthopedic surgery. Upon discharge, he was given Tylenol 3, but did not get pain relief. His doctor eventually prescribed high doses of Oxycontin, which managed to control the pain somewhat, but was not very effective at providing long term pain relief. Jeff was beginning to get concerned about becoming addicted to these potent painkillers — until a Pillcheck test.

How Pillcheck Helped

The test results revealed that Jeff does not effectively convert both codeine (a component of Tylenol 3) and Oxycontin to morphine due to mutations in the CYP2D6 gene. This finding explained why Oxycontin did not provide adequate pain relief even at such high doses. For patients like Jeff, Morphine is more effective at managing pain. With this new information, Jeff’s doctors developed an alternative treatment plan that included Gabapentin (to treat nerve pain) and a sustained-release formulation of Morphine, along with physiotherapy sessions. Jeff’s foot healed and his pain was finally managed properly; he felt much better and was able to return to work.


ron_cardio RON’S STORY

Ron was prescribed several cardiovascular medications after suffering a heart attack. He wondered why he suddenly developed shoulder pain and suffered a second heart attack. Pillcheck provided the insights he and his doctors needed.

After a tough day at work, Ron suddenly suffered a heart attack. A major artery in his heart was blocked, and surgeons inserted a stent to open it. His doctors gave him prescriptions for four different medications: Aspirin and Clopidogrel (PLAVIX™) to reduce blood clotting; Simvastatin, a cholesterol lowering drug; and Captopril, an antihypertensive drug. This combination of drugs is designed to reduce the risk of a second heart attack or stroke.

However, despite being on this drug therapy for several months, Ron experienced a second heart attack. Also, he was experiencing severe muscle aches and pain in his right shoulder for the past few months, and the muscle stiffness seemed to be getting worse. Ron’s wife had read that variations in a person’s DNA determine whether or not a drug will be effective or cause adverse side effects, and suggested that he get the Pillcheck test to better understand how he is metabolizing his medications.

How PillCheck Helped

The test results revealed that Ron is a poor metabolizer of Clopidogrel because he carries a certain genetic variation in his CYP2C19 liver enzyme. Ron and his wife learned that 16-30% of Clopidogrel users are unaware that they cannot metabolize the drug and remain at high risk for stroke and heart attack.

It turns out that Ron’s shoulder muscle pain was caused by an adverse side effect of Simvastatin, known as statin-induced myopathy, which, in rare cases, can result in kidney damage. Ron carries a mutation in the SLCO1B1 gene that predisposes him to statin-induced myopathy.

Acting on this information, Ron’s doctor stopped Clopidogrel and switched his medication to an alternative drug that is not processed by the CYP2C19 enzyme. The doctor also substantially reduced his statin dose, prescribed CoQ10 and recommended physiotherapy for his shoulder. Ron is now responding well to his treatment and has resumed his active lifestyle.

Skip to content