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GeneSight: Genetic Test Predicts Best & Worst Antidepressants for Each Person

It’s no secret that depression is becoming one of the biggest epidemics in the United States and throughout the world. Many people suffer from mental illnesses, but depression is a condition that seems to affect everyone at some point in their lives. Unfortunately there is no pill that will cure depression, but there are various medications that help individuals manage their depressive symptoms.

Instead of making lifestyle changes such as eating an optimal diet for mental health or pursuing natural cures for depression, most people seek out the help of antidepressants. There is nothing wrong with taking an antidepressant medication if you are on your last leg and no lifestyle changes have helped. The problem with medications is that many people end up playing “antidepressant roulette” or hopping from one drug to another and getting unsatisfactory results.

GeneSight Psychotropic: Genetic Test Recommends Best Antidepressant Treatments

Fortunately, there is now a new strategy being implemented by some healthcare practitioners. It involves taking a look at a patient’s genetic profile to determine how they are likely to respond to certain antidepressant medications. It has long been known that many individual factors play a role in determining whether an antidepressant medication will work.

A new test called “GeneSight” developed by the company Assurex assesses an individual’s genetic profile to determine how a particular antidepressant may affect their metabolic processing as well as response to FDA-approved drugs utilized to treat depression. Therefore, not only would this new test aim to determine whether a certain medication may make you gain weight, but it would attempt to predict whether the drug would actually improve your depressive symptoms.

  • How it works: The GeneSight test functions by taking a swab from the inside of your cheek to obtain a sample of saliva. The saliva sample is then sent to the laboratory for analysis. The analysis involves looking at 8 specific genes that are commonly used to metabolize medications as well as those that are associated with serotonin.
  • Metabolic responses: Individuals who have quicker metabolic responses to medications may end up with inadequate amounts of the drug in their system. In other words, those who predictably will have faster metabolic reactions to an SSRI may end up metabolizing most of the drug and not getting a proper antidepressant effect. On the other end of the spectrum are those with slow metabolic responses, resulting in too much of the drug being used or feeling over-drugged.

The test then attempts to determine which drug will be optimal based on genes that regulate metabolic processes. In response to the testing Anthony Rothschild was quoted as saying, “If serotonin regulation and transport is normal, antidepressants that are selective serotonin reuptake inhibitors, or SSRIs, are probably not likely to be effective.”

GeneSight Trial: Suggesting antidepressants based on individual genetics

GeneSight is attempting to help psychiatrists make smarter decisions when prescribing antidepressants. They are essentially trying to save patients unnecessary trials and tribulations associated with medications that are unlikely to work. Many people end up trying medications for months at a time, and often get worse. The problem is that when a person continues to switch from one psychiatric drug to another, they often end up with an even greater chemical imbalance as a result of their medication “trials.”

This is because the new medication has created significant changes in physiological functioning before an individual switches to another drug. The GeneSight “test” is undergoing trial to determine whether it is likely to be accurate in predicting patient responses to antidepressants. Should such a test get approval, it would have potential to revolutionize the industry of psychiatry.

We already know that things like blood tests for depression are on the horizon as well as improved testing to establish the safety of antidepressants in humans (e.g. the Darwinian test) – this is all exciting for those involved in psychiatry.  However, we still haven’t managed to solve the modern day conundrum of determining efficacy and hierarchy of treatment options on a case-by-case basis.  This new testing would allow psychiatrists to develop a more individualized treatment protocol.

Potential Benefits of the GeneSight Test

The test holds potential for notable benefits, namely: predicting metabolic responses as well as whether a person is likely to experience symptomatic improvement on a particular medication.

  • Antidepressant prescriptions: If this test works well in predicting whether a certain antidepressant is more likely to help treat a person’s depression than another, a doctor won’t need to waste time with treatments that won’t work. This will lead to patients getting the antidepressant that is most likely to improve their particular mental illness.
  • Expansion: The company behind this test could theoretically expand their services to other genres of medications. For example, someone who is in need of a treatment for pain or high blood pressure may benefit from a particular medication or classification of medication over another. Individualized testing would be able to determine whether one medication is safer than another in regards to the person’s genes.
  • Individualized treatment: I recently wrote an article about how to improve psychiatric treatment outcomes by utilizing data tracking via brain scans. If this gene test works well enough, it will lead to people getting the individualized treatments that they need. In psychiatry, everyone with depression is essentially at the mercy of a random treatment selected by their doctor. In many cases the treatment selected will not end up working. This test will essentially weed through the many treatments that are unlikely to offer benefit.
    • Mechanism of action: Why does one SSRI work for one person, but a different SSRI works for another? This has a lot to do with the particular mechanism of action of the specific drug. Two people may find benefit from SSRI medications, but differing mechanisms of action determine how a person is likely to react to the drug. Both people may need a serotonin increase, but genetic profiles and physiology determine which particular SSRI works best.
    • Neurotransmitters: For some people, an SSRI medication may be the best treatment option, but for another individual an atypical antidepressant that affects norepinephrine and dopamine may be a superior option. This test will give psychiatrists some insight as to whether the person being treated would benefit from a serotonergic antidepressant or whether they should pursue another treatment such as with an NDRI.
  • Low risk: Even if the test doesn’t work for 100% of people, it is extremely low risk. All that needs to be collected is a saliva sample, and even if a medication is recommended that doesn’t end up working, it’s no worse than getting prescribed a drug at random. Therefore the gene test poses no risk to the patient.
  • Metabolic response: The test appears to test for genes that are involved in drug metabolism. They are then able to predict the speed by which your body metabolizes a particular antidepressant. You may metabolize one drug too fast, leading to poor efficacy of the medication, and another drug too slow, leading to abnormal side effects. The test searches for a drug that your body metabolizes at an optimal speed.
  • Predict side effects: In the future, they may be able to analyze your genes and determine what side effects you are more likely to experience based on your genetic profile. Some antidepressant side effects such as weight gain, sexual dysfunction, etc. may be predictable based on how you are genetically programmed to react to a specific drug.
  • Prevent adverse reactions: Each year there are thousands of adverse reactions to medications. Although not all of these adverse reactions stem from antidepressants, many do. This particular test may help psychiatrists determine which medications are likely to be problematic and cause adverse reactions.
  • Save time / stress: Most people on antidepressant medications end up trying many before they find a treatment that works. Instead of blindly throwing medications at a patient in hopes that something works, a doctor will have a better idea regarding what is likely to work. This will save the patient the time of undergoing a medicinal trial for a drug that is unlikely to help.

GeneSight Details: Using a “Traffic Light” System

Once results are assessed from the collected saliva swab, GeneSight is capable of categorizing over three dozen antidepressant and antipsychotic drugs. The results will then give a color-based rating based on an individual’s genetic profile. It uses a stoplight system to identify which drugs would be of benefit, which should be used with caution, and which should not be taken.

  • Green: These are medications that a patient is likely to benefit from and should be used as indicated. A person who’s test produces a green light next to a particular drug is likely to metabolize the medication optimally and improve in their depressive symptoms. Just like the stoplight, green means it’s okay to “Go.”
  • Yellow: These are medications that a patient may benefit from, but should be used with caution. As a stoplight reference, yellow means proceed with caution. This means that a patient could have problems with the drug, but may still get some benefit from the drug.
  • Red: These are medications that a person should probably not use. Those who test “red” for particular medications are more likely to have adverse metabolic responses to the drug. If a patient is prescribed a drug that shows up “red,” they likely need more extensive monitoring.

GeneSight Trials: Determining The Accuracy of the Test

The GeneSight testing is undergoing trials among psychiatrists to determine its accuracy. One psychiatrist ended up sharing how the trials are being conducted. Anthony Rothschild, a psychiatrist at UMass Medical School said, “For half the patients, I will be guided to strongly consider the green light medicines identified by the test; for the other half I will not use the test, just my own judgment, to prescribe for the first 12 weeks.”

He then stated, “After 12 weeks, whether the person is better or not, I will share with them the results of the test. If they’re better, fine. If they’re not better and I haven’t been using the test, I will use it. Or if I was using the test and they’re not better, I will consider another green light medicine for them to try.” The accuracy of the testing is currently unknown, but more data will likely surface as GeneSight trials progress.

Final thoughts on GeneSight testing…

GeneSight has potential to revolutionize psychiatric care with the development of this new test. Assuming that it is found effective, many patients will be able to avoid drugs that are likely to cause more harm than benefit. Additionally there are no inherent risks associated with this type of testing – it is non-invasive and won’t affect the quality of psychiatric care a patient receives.

These days psychiatrists simply pick an antidepressant and hope it works. Assuming GeneSight doesn’t work, it will have done no harm to the patient because psychiatrists will remain prescribing antidepressants at random. However, assuming it does actually work, patients will be prescribed medications that actually improve their symptoms and that they can tolerate.

I’m all for genetic testing to determine how a person is likely to react to psychiatric medications. It can only be hoped that GeneSight expands to genres of medications other than psychiatry as well. It has the potential to be used universally by all doctors and for all medications assuming different types of tests are eventually developed (e.g. test to determine which opioid will work the best).

So would you get the GeneSight test before taking an antidepressant? Feel free to share your thoughts in the comments section below. Assuming the test works, even a little bit, I feel like it’d be a no-brainer to get the testing and avoid medications that could potentially make you feel worse.  It should also be mentioned that creating a test to determine the degree of benefit a person would derive from specific dietary alterations, sleep changes, exercise, and/or various supplements would also be of significant help in improving various conditions such as major depression… these recommendations are likely currently too advanced for this initial protocol, but the future possibilities of genetic testing are seemingly endless.

  • Source: http://genesight.com/patients/genesight/psychotropic/

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{ 25 comments… add one }
  • Jill September 12, 2018, 6:47 am

    Either I received the wrong results, or this test was a complete failure. I had three antidepressants which where on my green list, all have failed and I have had the worst side effects.

    Now the doctors won’t touch the ones in the red area. Oh, there are only two in the yellow which didn’t work. Thanks a lot, waste of time and money!!

  • Kathryn August 17, 2018, 1:16 pm

    I would be very interested in doing this test as I’m not sure my antidepressants are the right ones. I live in the UK.

  • Francesca Huneeus April 14, 2017, 12:57 am

    Today I just took the swab test for GeneSight. I have tried several types of antidepressants with no success. I hope this form of genetic testing
    will narrow down an effective medicine that will lift me out of the darkness.

  • Mushi January 16, 2017, 2:34 am

    To those who say Genesight testing doesn’t work – are you switching from SSRIs, for example, to NDRIs? I ask because when switching drugs you will agency withdrawal effects that you or your doctor may mistake as bad side effects of the new drug you’re taking. I’m experiencing this right now! My green light drug works to block dopamine, not serotonin like my previous drug did.

    I am now going through severe serotonin withdrawal!! This is a whole separate issue that MANY are suffering with… sometimes years!! Google antidepressant withdrawal… to read thousands of real stories from real people sometimes going through YEARS of withdrawals after stopping and yes even tapering SLOWLY from a medication they’ve taken for months or years. This is a huge problem IMO that needs more recognition and attention from the medical community!!

  • Aby Nash January 12, 2017, 1:45 am

    I took the test and surprisingly the med they said is best (Wellbutrin) have the worst side effects. Some of the Red Light meds actually did work for me for a while. I won’t put a whole trust in this test.

  • Darlie December 23, 2016, 5:05 pm

    Took this test. In the green category, the first drug listed is one I definitely knew I could not take as it works by increasing dopamine levels however, I have multiple And many DBH mutations which means I cannot effectively convert dopamine into norepinephrine. The result of taking this green light drug would be a build up of dopamine creating very high anxiety and panic, perhaps mania as well.

    Because Genesight does not check all genes, their results are a half hearted attempted. Oddly enough, the drug the doctor currently had me on seems to be helping. I need to do a bit more research of all my genetics, not just the few that Genesight tested me for. My advice, proceed with caution. Genesight does not test enough genes for it to live up to its claims.

  • Jim October 9, 2016, 10:11 pm

    I wish I had known about this test sooner. After 11 years on either Lexapro or Zoloft for severe anxiety and depression, I recently switched to Effexor XR because the others didn’t help enough on the anxiety side. After only 2 months, I’m symptom free on the lowest dose of 37.5 mgs. I was on the full doses of the other meds and they didn’t work as well.

  • M September 4, 2016, 2:10 am

    We are still in the dark ages with mental health treatment. I’m greatly interested in this new technology.

  • Laura August 20, 2016, 7:08 pm

    My son (18 yrs old) who suffers from bi-polar disorder just had this test done. We are awaiting the results. My husband and I are very excited about it as it will determine what meds will be good for him. He has tried many meds, and most do not work. Or worse the side effects are worse then the disease itself!! I think this test is so IMPORTANT!

    I just do not understand why it was not suggested to our son years ago!!! It would have saved him from a suicide attempt, 2 psychiatric hospitals, thousands of dollars in doctor bills and meds… but most important our sons well being, his self esteem, his feelings and quality of life!!

    • Ivan November 4, 2016, 4:12 am

      Laura, I’m a 17-year-old boy and I suffer from severe OCD. I want to go to my pediatrician and ask him to administer the test for me, although he would first have to register with them. I wish you the best with your son and believe me, I know how horrible it is to suffer from depression. I’ve correctly been diagnosed with OCD, ADHD, and Major Depression.

  • Kryste Southwick April 21, 2016, 10:10 pm

    I was treated for anxiety and depression for years. Nothing worked. My doctor did the Gene test. I was on all the wrong medicines. Now I’m on Viibryd which was one of my green lights and I actually feel pretty good. I am glad it’s no longer a guessing game.

  • Megan Thomas April 19, 2016, 1:38 am

    I’d love to get the testing done. I called to check the price of the test and it was way too much for me to afford and my insurance doesn’t cover it, so sadly I can’t have it done. I believe that it’s worth every cent that it costs, but I just don’t have that kind of money. I’d say that it will be rare that people do.

    I’d love to have this done, though! Hopefully I’ll be able to some way. My psychiatrists have tried countless amounts of medications with me and none seem to work, though I also suffer with bipolar disorder as well. If available through insurance or somebody has the money then I’d recommend anybody get tested!

    • Kryste Southwick April 21, 2016, 10:16 pm

      The company charges according to your income. If my insurance continues to deny these charges I only pay $125. If you make under $75000 it’s $125 and you can make $25 payments. If your income is over it’s $325 or $375 can’t remember and they break it down to monthly payments. Another words yes the test can be over $6000.00, but with proof of income you do not pay that much. Very reasonable and the company is great to work with. Good luck.

  • Mel March 29, 2016, 12:50 am

    GeneSight has a website with information and a number to call. They can give you a list of doctors in your area who do the test. Good luck to whoever tries it!

  • Jennifer January 5, 2016, 9:25 pm

    I would absolutely love to have GeneSight testing done, considering all the medications I am on. In fact, GeneSight could have saved me from almost losing my life. I was prescribed Lamictal for migraine prevention. Not only did I gain weight, I became suicidally depressed and actually made several suicide attempts. It was the weight gain that finally clued me in that it was the Lamictal.

    In contrast, Gabapentin has been a miracle drug for me. It has almost stopped my excruciating back spasms with no adverse side effects. Those are only two examples, but before taking any new medication, I’m going to ask my doctor about GeneSight testing. I’m so glad I read this article prior to my next appointment.

  • Kathy Kisner December 8, 2015, 11:46 am

    The GeneSight test sounds like just what is needed to get my husband on the right medication for his major depression/psychotic disorder. Does every psychiatrist know about and refer for this test? Where is the testing being done in SC?

  • SandFranz October 17, 2015, 7:24 am

    I’d love to get this done – if it’s not merely some kind of money-making joke. I’ve had an ileostomy for Crohn’s disease and as a result, a shortened bowel. I’d love to know how much of a drug I’m absorbing versus how much is “washed away” by my super speedy digestion. I can’t, for instance, take time-released meds because nothing stays in me long enough to absorb. And, pardon me for the graphics, but salads go RIGHT through me. Anyway, let’s do this! I’m tired of spinning the anti-depressant wheel and hoping one works!

  • Meredith September 28, 2015, 7:01 pm

    I would LOVE to take this test, but I don’t know where to go to get it or who to talk to about it. I have been on the roulette wheel for over 30 years and doctors are still throwing darts. I am tired of it. How can I get one of these tests done?

    • John October 29, 2015, 9:47 pm

      I called the local Mental Health Association; they gave me a good lead. Finally, a doctor suggested I call a psychiatric outpatient clinic and, BINGO! They administer the test. The attending psychiatrist said that many people (especially seniors) do not absorb anti-depressants because of Vitamin D3 or B deficiencies. So, have your blood checked for those conditions as well.

  • Luna September 8, 2015, 4:24 am

    Is this test available? I would try it. Having been a guinea pig for at least a dozen doctors who refuse to acknowledge that psychiatric medicines have side effects, and having suffered from just about every side effect there is (except heart attack, death, stroke and tardive dyskenesia), I am fed up with the “shoot in the dark” practice of psychiatrists. I often wonder why general practitioners can’t do the job psychiatrists do. It’s not like clinical experience in psychiatry improves outcomes in patients.

    I’ve had friends who are on 19 psych meds, 11 psych meds, 14 psych meds, I even know a man who was on psych meds and each time he had a bad side effect, the psych doctor added another medication to treat the side effect This man was on 47, yes literally 47 medications. He had a stroke last month, and instead of reviewing all of his medications, the psych doctor just added a blood thinner.

    Now this man is on 48 meds. I asked him if he questioned the psych doctor about this, and he said that doctors know medications better than he does. Why do so many psychiatrist practice polypharmacology? Are they getting kickbacks? I am sick and tired of my friends ending up on dialysis, or with liver failure or type two diabetes or non-diabetic peripheral neuropathy because psychiatrists believe that “more is better” (that is a direct quote from a local county employed psychiatrist) when it comes to treating chronically mentally ill patients.

    I recently had a friend kill herself because the doctor put her on 20mg Zyprexa for insomnia and she gained a huge amount of weight. The doctor told her there was no other medication for insomnia, she couldn’t stand the humiliation of being fat in this society, so she hung herself. As if being mentally ill isn’t bad enough already, the side effects of these medications make everyone sicker.

    I take medication, but I try to advocate for myself by reading up on any med my doctor suggests before I take it. I truly hope that someone comes up with a way to clean up side effects so that people like me and my friends don’t have to suffer like this.

    • Tim September 9, 2015, 9:10 pm

      Hey, it is available and I just had it done this morning. I won’t know the results for a couple weeks but I am excited that it has the possibility of pinpointing the drug that will work best for me. The only drug that I have ever taken for anxiety/depression was Paxil. I took at a low dose for almost 9 years and it pooped out. I am OK with taking something to help with my symptoms but I don’t want to be on one medication to offset another’s side effects. My insurance covered the test.

      • Kim March 11, 2016, 9:25 pm

        I have been struggling with side effects from the medicines my psychiatrist has been prescribing me. I went to a homeopathic doctor and she suggested GeneSight. I asked my psychiatrist about it and she was all for it. Now, I’m just waiting for my insurance approval. If they don’t approve it, I’ll probably get it done anyway. Hopefully, it will be cheaper in the end knowing what works and what doesn’t because I’m wasting money on medicines that don’t help me.

  • FoonTheElder May 15, 2015, 7:48 pm

    My wife had this done. It recommended the new, most expensive drugs on the market that were not particularly effective. I also noticed that the list we were shown almost completely matched their “sample” on their website.

  • Joan Munro January 17, 2015, 5:03 pm

    If this test works it will be a tremendous step forward in assisting people struggling to find an antidepressant medication to help them. Thank you so much for all of the informative articles that you write, they are very much appreciated.

  • Linda Schoenbein December 30, 2014, 10:06 pm

    I absolutely agree with this article. Plan to get the test done during my next appointment. Made sure my physician is registered to give the test, checked with my insurance on coverage…even if insurance doesn’t cover this test (which makes no sense because of wasted medical costs associated with repeated physician visits, prescriptions filled, but don’t work, wasted time, etc.,) I would pay for the test and insist my clinician make this test available. Thanks AssureRX and Genesight for investing the time and money to make this available to people who may be struggling with major depressive disorder, anxiety, PTSD, pain and or ADHD. It’s about time!!

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