Adolescent boxing during fitness class

Pharmacogenomic Testing

GeneSight® Pharmacogenomic Testing Informs Teen Treatment at Muir Wood

Most patients who are dealing with substance use disorder, including the adolescents that we see here at Muir Wood, typically experience one or more co-occurring mental health issues, including depression, anxiety, post-traumatic stress disorder, schizophrenia, or bipolar disorder. These conditions contribute to the complexity of substance abuse treatment. These mental health issues are frequently addressed in part through the use of psychotropic medications such as antidepressants as well as through behavioral therapies such as CBT, DBT, EMDR and others. In the case of treatment through medication, different people respond in different ways. A drug that may be effective with one person may do little for another. Often, several such medications may be tried before finding one that is effective for a particular patient.

The relatively new field of pharmacogenomics seeks to address this problem. Pharmacogenomics examines genes that affect how an adult or adolescent will respond to a particular medication. This gives psychiatrists a better idea of which medications will work for which patients, eliminating the trial and error approach that normally accompanies psychotropic prescriptions. Pharmacogenomic testing can indicate which medications may be effective, which may perform poorly, and which could have detrimental effects.

“Selecting the appropriate medication for a patient is generally multifaceted and nuanced. Some factors rely on patient report and other subjective factors. Before pharmacogenomic testing, there were few objective, evidence-based biomarkers for medication selection and dosing in psychiatry. Now we are learning amazing things about the interaction of DNA (our genes) and medications we prescribe.” – Muir Wood Psychiatrist and Medical Director, Michael Genovese, M.D.

Muir Wood is one of very few substance use and mental health treatment centers that employ pharmacogenomics as part of treatment. We work in partnership with GeneSight®, which has developed testing protocol that examines twelve genes associated with how the human body reacts to psychotropic medications. The testing allows us to weigh the influence of these genes on a teen’s response to over 55 different psychotropic prescriptions. The report generated categorizes each drug according to its appropriateness for the treatment of a particular teen. This allows our highly credentialed clinical and medical teams to prescribe the medicine that holds the most promise and least downside for our teen clients. Studies of GeneSight’s historical results show that 50 percent of participants experienced an improvement in remission rates and 30 percent showed an increase in response rates at week 8, with a continuing increase in remission and response rates throughout the 24-week study period that was used.

At Muir Wood, we are committed to exploring every emerging treatment technology that could the help the teens in our care ease the pain of co-ocurring mental health issues and break the hold of a substance use disorder. Pharmacogenomic testing is just one of the approaches that set us apart from other teen treatment centers.