Yay or Nay to DNA?

On the television series Star Trek, medical officer McCoy could simply wave a device over a patient and know what was wrong with him. This type of instant diagnosis is still futuristic, but it is getting much closer.

Now a simple oral or saliva specimen may help your doctor with treatment decisions.

These pharmacogenetic tests use the patient’s DNA to suggest personalized treatments for pain management, mental disorders, cardiovascular disease, and to help with addiction therapy.

The problem is that the treatments suggested by the tests are not always effective.

“Genetic testing is not as great as we want it to be,” said Beaumont psychiatrist Dr. Rosa Gonzalez about pharmacogenetic testing as it applies to mental health.

The good news is that the test is very easy to administer. A simple swipe under the gum lines with a large cotton tipped swab is all it takes. The swab is sent to the testing company, and within days the doctor has the results.

“For some people it does work and sometimes it doesn’t,” Dr. Gonzalez said.

Beaumont native James Elliot (pseudonym) has benefited somewhat from such a test. Elliot suffered from anxiety from a very young age. It manifested into a panic attack when he was 16 years old.

“I was constantly worrying, feeling like I was losing control,” Elliot said. “It’s relentless. It’s a very scary deal.”

It took doctors years to find the correct medicine and dosage for Elliot.

“They have to build up. It can take four to 12 weeks to get to a steady state,” Elliot said of the drugs used to treat anxiety.

“The Millennium PST (a pharmacogenetic test) showed I was an ultra-rapid metabolizer and was burning the medicine up so fast it could never get to a steady state,” Elliot said.

His test showed Elliot’s doctor medications that may work better with his metabolism and build to the steady state needed for results.

The tests results may indicate possible dosage levels, and which medicines have a potential of causing severe adverse reactions.

A doctor can choose from 38 different psychotropic medications to treat mental disorders. The pharmacogenetic tests are meant to help a doctor narrow the list of which medications may work best for the tested patient.

Before pharmacogenetic tests, finding the right medication for a patient could take months or years. During this trial and error, the patient continues to suffer and the costs add up.

“It’s not an exact science yet. It is a tool for patients who have tried many different medications. It may be able to give you certain clues,” Dr. Gonzalez said.

“I don’t want patients to think it’s the answer,” she said regarding the test.

“It’s just another tool for your doctor,” Dr. Gonzalez said.