Has anyone taken the GeneSight test? What was your experience, was it helpful for your medication management?

[Great_Artiste]

I just received a copy of my GeneSight test results in advance of an appointment with my psychiatrist. I have some preliminary ideas as to how to interpret and use this info.

Some background: I have Bipolar II and ADHD-C. I've been on 18mg of Concerta since January 2021, until the last couple of months. I started feeling more anxiety/hyper-ness/hypomanic. I started taking longer & longer breaks until I stopped the Concerta completely. For 7 years a previous doc refused to try stimulants, only non-stimulants which did nothing except give me side effects. Tried Adderall XR briefly, but it felt too powerful. When my dr. tried switching me from 600mg Lamictal to Depakote ER. That's when I discovered my Lamictal dosing was too high. Being off of everything, I started thinking more clearly, despite my unstable quickly shifting mood swings.

My opinion is that even if the results say I am a quick metabolizer of Lamictal, but I can take a list of other meds without a problem (I really can't, the side effects were intolerable). I don't agree with some of the specifics for me. I think it's not as precise as people and doctors say it is. It's useful, but it's not as precise or an accurate predictor of how a particular med will work in you.

What do others think?

[Gettingittogether]

I haven't taken time to learn more about these types of tests. I assume that when they become more reliable, they'll get more adopted by psychiatrists and pharmacy companies. Anything that gives you insight (or even hope), go for it!

I still think a huge part of the process of mental health treatment is trial and error with medications and doses and combinations of medications with varying doses.

[Great_Artiste in reply to Gettingittogether]

Agreed. Genetic tests based on current research will get better. It's a slow process to take the research and implement them into real-world practical info that helps us. Even physical health treatment is trial and error. For those conditions, doctors have more tools to suss out what works and what doesn't. I think psychopharmacology is transforming into more accurate and quicker medication optimization. I have to keep reminding myself that the brain is the most complex organ in the body. Psychiatrists have a Sisyphean task (rolling boulders uphill). Non-psych doctors are really for getting the maintenance meds that work for you. Hopefully, they're not close-minded and are willing to work with you.

[FindingTheAnswers]

Hi GA. I took a test like this years ago (don't remember the namer brand. I didn't much out of it. I agree with what you said that, " it's not as precise as people and doctors say it is. It's useful, but it's not as precise or an accurate predictor of how a particular med will work in you." But that's was my experience. The only thing I remember, was that it said my brain would be prone to be Folate deficient. Some people have a problem with Folate passing the Blood / Brain barrier: pubmed.ncbi.nlm.nih.gov/281...

The test recommended I take a special type of Folate to accomplish it '5-MTHF (L-5-Methyltetrahydrofolate'(?) and it has to be taken with another vitamin, B12(?). At that time, it had only 1 manufacture. My insurance company considered it a.... "Nutritional Food"(?) so they didn't cover it, and it wasn't cheap.

Now you can get it on-line as Methyl-Pro at Amazon, etc.

Unfortunately, it didn't do anything for me. Sorry for the dissertation.

[Great_Artiste in reply to FindingTheAnswers]

9 years the only mega-dose Methylfolate on the market was absurdly priced, about $300 or so if memory serves. My doctor had lots of samples that he gave me, and after 3 months, I stopped taking them. Why? I felt no difference. I was pretty sure at that point that I didn't have the gene defect. Otherwise, I would have felt a difference. I got my results for the entire GeneSight test this week, but the Dr. had also added the MTHFR gene to it. Result? Yup, I was normal, confirming my original hypothesis. Apologies unnecessary, Finding. I live for the details, lol.

[Great_Artiste in reply to FindingTheAnswers]

No apologies necessary, I do the same myself. People, especially my brothers, don't want to hear the details: "get to the point!!!" (esp. now that I'm hypomanic and still not properly medicated/stabilized). I'm getting better every day now. Progress isn't a straight line.

You have my permission to go on as long as you like, lol.

I learn a lot from other people's detailed stories. It's a relief for me to unburden myself, share and learn from others as well.

[addacademic]

The psychiatrist is obviously the most qualified person to answer your question. But I can repeat what mine told me. She said that it's helpful in some cases to reduce the trial and error part of medication management, particularly in patients who have failed on two or more antidepressants, but that it doesn't always provide as clear answer as they would like.

Now, that was a conversation about MDD. For bipolar and ADHD, I can't relay any further info from her. (No one ever really questioned which stimulant worked well for my ADHD, only my antidepressant for MDD - and I've never had bipolar, as exciting as hypomania sounds to me (ironic joke.)

I do get the sense that there's a bit of hope that the gene testing can become a good objective diagnostic tool to improve outcomes in psychiatry - a medical field that has been waiting for breakthroughs for a while now - but that it might not quite be ready for primetime

Your psychiatrist almost certainly won't rely on the genetic test alone to determine what meds would be best for you. That's a good thing.

Talk through your concerns about the test with him/her. They know what the data says about these gene tests and can help you avoid misinterpreting or misapplying the information it gives you.

Good luck.

[StoneJeweler]

Aloha,I have been treated for ADD, and depression for over 14 years. I used Adderal XR mostly and it worked ell until I was forced to switch to the generic. I tried several pharmacies but they barely worked for me. I also tried several antidepressants Wellbutrin, prozac, and a few others. Some worked at first but now know of them do. I am a RN, frustrated I decided to do some lab work, the generic labs were always normal, so I looked into other types of lab work. I found several vitamin and mineral deficiencies which I have been working on and getting some relief. I did an Organic acid test from Great Plains lab and found one major problem. I had high Quinolinic acid results which according to my research on line, it causes inflammation in the brain, it said that taking antidepressants like prozac will not work because it does not deal with the inflammation in my brain. So I quit prozac, started taking supplements that delt with brain inflammation, like broccoli extract, melatonin, turmeric, acetyl L carnitine and more. Do not take tryptophan.(read on internet).

I also eat only organic foods, which is helping-no more pesticides, herbicides etc which cause leaky gut problems and make the blood brain barrier leaky also. I am slowly getting better for the first time and I will continue to bring body back to a healthy state.

It is important to realize that treating ADD/ADHD is a multi- faceted approach. Just like treating Alzheimers is.(See DR Bredeson). Hope this helps. Dianna

[Great_Artiste in reply to StoneJeweler]

Aloha and Shalom. Thanks, Dianna. More info really helps! 🏝️😃

[Phianoposis33]

We did it.My son was on prozac and had really bad issues on it. Come to find out that was one drug he shouldn't be on.

But then he was on adderal XR for years. (genesight said OK) It seemsed to help at first. Then it didn't. Instead of trying something else his doctor kept raising the dosage until lately he was up to 60mgEX a day. Then the anger and irritability started along with anxiety. So lets add hydroxyzine 150mg daily for anxiety and abilify for anger.. Then lets have a manic episode. Hospitalized they took him off everything and he's just on depakote now and doing so much better.

What I would take from this.... It might help but it all depends (hence the adderal situation)

If you're on a med, and it causes a side effect like anxiety. Don't have your doctor prescribe you something for the anxiety. Change the med that is causing you anxiety.

My son was getting all these other symptoms and his doctor just kept adding meds to treat those symptoms. Not good.