Welcome to part 3 of my GeneSight series! I have submitted my spit and received my results! Did you miss my intro and/or procedure posts? You’ll want to read those first. This is the longest and most complex of all of them. I hope that you will find it as interesting as I do.
I received my reports within 2 weeks from my healthcare provider and was eager to see what they said. The GeneSight Psychotropic test report is 9 pages long and my GeneSight MTHFR test report is one page. Are you ready to hear about how my genetic makeup affects the way drugs work in my body?
The reports are pretty easy to read. My provider showed me an example of a report that he receives, which is color coded. Green means “Use as directed.” These are the medications that your body doesn’t have any issues responding to. Yellow means “Use with caution.” These have a moderate gene-drug interaction, so they might not work well for you. Finally, red means “Use with increased caution and more frequent monitoring.” These have a significant gene-drug interaction. Pages 1-4 of my report feature the green/yellow/red gene-drug interaction results.
The psychotropic test analyzed my gene-drug interaction with 22 antidepressants, 12 anxiolytics and hypnotics, antipsychotics, and mood stabilizers. Most of the drugs fell in the green category (note: my report printout is in black and white, but it is still very easy to interpret). I have moderate gene-drug reactions with 2 antidepressants: doxepin (Sinequan) and fluoxetine (Prozac) and one antipsychotic: asenapine (Saphris). I have never tried any of those medications. I have significant gene-drug interaction with one antipsychotic: olanzapine (Zyprexa) and two mood stabilizers: carbamazepine (Tegretol) and lamotrigine (Lamictal). I have tried the mood stabilizers and experienced side-effects that led me to see my prescriber and change meds. Note that the mood stabilizers Neurontin, Eskalith, and Topamax do not have proven genetic markers, so I have no results for those.
If a drug has a gene interaction, the reason is notated. For example, both of the antidepressants that are in the yellow zone might require lower doses because of high serum levels.
The next two pages of the report are more complicated to read and understand. These pages list “patient genotypes and phenotypes,” with pharmacodynamic genes on page 5 and pharmacokinetic genes on page 6. Some definitions:
- Genotype: genetic makeup
- Phenotype: observable characteristics (based on genotype/environment interaction)
- pharmacodynamic: drug effects and how they work
pharmacokinetic: movement of drugs within the body
These reports seem to be mostly full of “normals” for me, which is good (I think). There are a couple that are not normal, which leads us to the next section: a 2-page table with all of the drugs listed on the left side, all of the genotypes listed across the top, and a key at the bottom that has the following two options:
- A solid black circle = “Variation was found in patient genotype that may impact medication response.”
- An empty circle = “This gene is associated with medication response, but patient genotype is normal.”
I have 18 drugs that have solid black circles under one or more genotypes: (Wellbutrin, Remeron, Zoloft, Effexor, Trintellix, Valium, Lunesta, Restoril, Ambien, Clozaril, Prolixin, Haldol, Depakote, Sinequan, Prozac, Saphris, Zyprexa, and Lamictal). I have been on 10 of these drugs and I currently take high doses of Depakote. It would have been cool to have these results 16 years ago, when I first sought treatment for my issues!
Page 9 is the last page of my psychotropic report. It lists all of the details about the test (specimen collection details, a list of scientific procedures performed on the sample, etc.), a statement that the test hasn’t been approved by the FDA, a disclaimer of liability, customer service information, and a signature from the doctor that verified the report.
The last page of my document is a 1-page report on my folic acid conversion test. The MTHFR results are reported in a very simple and straightforward manner. A check mark is located in one of three categories: “Normal folic acid conversion,” “Reduced folic acid conversion,” or “Significantly reduced folic acid conversion.” I have reduced folic acid conversion. Just like the psychotropic test report, this report also has a short genotype/phenotype section. Based on my genotype, it is expected that I have reduced folic acid metabolism, moderately decreased serum folate levels, and moderately increased homocysteine levels. The report states that my serum levels may be too low and folate supplementation or higher daily intake of folic acid may be required. I will discuss this with my prescriber in April. Again, test information, disclaimers, and so forth are listed and the document is signed by someone who verified it.
This is getting to be a ridiculously long post, so I think I will stop here and say “to be continued” until after my follow-up appointment.