You know the phrase, "if I had a nickel every time I heard this," well, if we had a nickel every time we heard a patient say that they were told this or that because of their genetic testing, we would have a lot of nickels!!!!
We were early adopters of DNA testing / Genetic Testing in Psychiatry in the clinical setting back in 2011, and on the frontline of the successful use and application of Genetic testing, but we are also very aware of how the testing is misinterpreted and misunderstood.
Personalizing your Treatment in Medicine
Reviewing a patient's Genetic testing allows our office to more quickly identify treatments, medicines and dosages to maximize clinical benefit for patients. When our clinicians consider a patient's unique genetic profile it helps them better determine treatment options for care with depression, anxiety, or other mental health conditions. We see that the patients do better on antidepressants and other medications that are specifically selected for their metabolism. These patients get well faster than when we do not have the genetic results and some research has confirmed this observation. Genetic testing provides clinicians additional information that frequently helps optimize the treatments and dosages for individuals.
How it works
We use Genetic testing if it will help your care. This is not the case with everyone. If the team or the clinician recommends genetic testing, we send the patient an at-home Genetic kit which the patient can do in the privacy of their home. It is a simple mouth swab which is then mailed to the Genetic testing company. The fees for DNA-Genetic testing can vary depending on your insurance coverage and the types of tests ordered, but often comes with some out of pocket cost. The cost can be $300-$400 dollars, and while this may seem like a lot of money, this cost is small when you consider the time the results may save to get you well. We receive the results a few days after the company receives your sample and we will review the results at your follow-up visit.
Q: Should I have genetic testing for treatment?
Each individual patient is unique. Testing for genetic variations of the cytochrome P450 enzymes which metabolize most psychiatric medications can help us make better decisions regarding drug schedule and dose choices and minimize adverse effects of prescribed medications.
Our clinicians will recommend Genetic-DNA testing after the initial evaluation in our office if it is appropriate for you. If you want Genetic- DNA testing, make sure you mention it to our team. If it is appropriate, we will order the testing.
The FDA has guidelines for medication adjustments on over 120+ prescription medications, and if you are prescribed one of these medications, it will be helpful to know your genetic results.
Q: Will genetic testing help with my diagnosis?
No, unfortunately this testing can not help with a diagnosis. In fact, any testing that implies that you have or do not have a specific diagnosis can not be correct at this time. The Comprehensive TEAM Evaluation process, and the diagnostic screening tests & assessements which we do in the office will help determine your diagnosis(es). Genetic testing studies have shown that they can improve outcomes, and shorten time to recovery for patients. In psychiatry, genetic testing is NOT able to identify diagnoses as brain illnesses share many of the same pharmacodynamic and pharmacokinetic genes.
We find that genetic testing helps us finesse the treatment options.
Q: Can genetic testing tell me which medications to use?
Unfortunately, this testing cannot tell you which medications to use or not use; again that is a clinical decision based upon identification of a diagnosis or symptom profile. The genetic testing alone cannot tell you which medication(s) are best for your particular treatment; this is a decision which only your clinician and you can make. As there are often many options, a clinician trained to help with brain diseases and skilled at reviewing genetic testing, can find the appropriate treatments for you and discuss which would be most appealing for you. According to the most recent research, the decisions informed by the genetic testing results, can often get you well,
more quickly than treatment as usual.
Again, we like Genetic testing to help us finesse a patient's treatment plan, but the testing is only part of the process.
Come visit us for care, most of our patients are from Nashville, Brentwood, and Franklin, TN areas, but patients come from all over to receive care.
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*as of April 2023, Nashville Center for Hope & Healing is a division of the NeuroScience & TMS Treatment Center