Genetic Testing for Anxiety Meds

[onedayatatime23]

Does anyone have any experience with using any test like this? Is it worth the money? Does it work? My son has been on 2 medications since last year for OCD/Anxiety (Lexapro and currently Prozac) and they work temporarily but don't seem to last. Not sure if a medication change is needed or the dosage needs increased (already increased 2x). Also if anxiety meds are working the way they should, wouldn't Xanax not be necessary? Thanks in advance.

[onedayatatime23]

Thank you for your response. He is on 60mg prozac and 2mg rexulti and still needs Xanax daily...just wondering if another medication would be better or to up the prozac to 80mg? the meds work in the short term but then the efficacy seems to diminish after a short time. He does see a Psychiatrist and a psychologist but after a year it doesn't seem any better...

[onedayatatime23 in reply to onedayatatime23]

22

[helloworld22 in reply to onedayatatime23]

Hello. I’m not a doctor, but I suffer from OCD. This is some information I think a number of people aren’t aware of but which is helpful. SSRI’s such as Luvox, Zoloft, Prozac, Lexapro, and others work, but they may take a while; in fact they usually take significantly longer to affect OCD than to affect depression. Also, you typically need high doses, maybe near max, of these to affect OCD. Based on evidence in literature and anecdotal evidence, it takes 12 to 16 weeks for SSRI’s to have significant effect on OCD. This longer time to start working is partly because the high doses make you consume time ramping up the dose. I believe the majority of the reason it takes a longer time to start working is because the kind of thinking changes that must occur to alleviate OCD involve more steps than for alleviating depression.

[avoidingthebadthings]

I'm sorry to hear about your son's struggles with getting a medication regimen that keeps working. I have never been able to be treated successfully for depression, anxiety, and OCD without the aid of Xanax.

The problem of depression/anxiety is much more difficult to treat than depression alone. Many anti-depressants are more "activating," so the patient's anxiety can be exacerbated. Xanax is great for dealing with anxiety, and if your son is regularly seen by a psychiatrist, then it's very safe to be on. Having the Xanax will really help your son's brain to slow down the overwhelming thoughts that go with OCD. Once he can think more clearly, he'll more easily be able to "see" the thought patterns and begin to get a handle on them.

I have never had genetic testing done for these meds. It's simply been a trial and error method. Usually I or my doctor can tell in a few weeks whether a med is promising or not, and whether it's worth trying a higher dosage. The drugs that don't work have often lasted about 4-6 months and then we'll realize that they aren't a good fit, so your son's experience doesn't sound unusual. Everyone's body is different, and these drugs interact differently in very complex ways that can take a bit of time to emerge.

It might be time to try an SNRI like Effexor. You might consider getting a second opinion from a different psychiatrist, or perhaps a different therapist might be a better fit to help your son with the OCD. It's a very tedious process to go through for both the patient and the parent, as, unlike physical injuries, there's no visible healing to give a sense of progress. It's a long haul situation with no instant magical fix. Your son is very lucky to have you advocating for him.

Do remember to take care of yourself and your own mental health during this time. Talking to a therapist or getting involved with a parents' support group can be really helpful. Also, an in-patient stay at a psychiatric facility where your son can be monitored daily during these medication changes could be helpful for both of you. Sometimes a very safe, quite environment without stressors can work wonders for the patient while in the early phases of getting mental health help.

[MrsMapdog]

I have had the genetic testing. I suffer from OCD/Depression and anxiety. Five antidepressants were on the list to work best for my body. The dr chose prestiq. I have to be honest and say that I can't say, Wow! I see a difference with a medicine that the genes test showed to be more favorable for me. But remember everyone reacts different to each medicine. I do use klonipin for my anxiety too. On another note I am a survivor of childhood trauma and I wonder if any amount of medicine, treatment or therapy can undue the affects of emotional and mental abuse I have endured.I wish the best for your son.

God Bless

[DocdMom in reply to MrsMapdog]

MrsMapdog- you are the only other I have heard prescribed Pristiq for OCD. My college aged son was prescribed 100 mg Pristiq after the genetic testing for his OCD/anxiety/depression as well. I can honestly say that as far as side effects, it has been the easiest transition with fewest problems as so many others had exacerbated his anxiety when going on, however we are questioning if it has been effective on his “stuck loops” as these seem to come and go in waves still. Better than staying active all the time though. He is also on Abilify but the doctor is considering changing that to Lithium based also on the testing. I have not heard of lithium being on the recommendedist of meds to treat OCD. (If anyone on this thread can chime in related to that med-I would appreciate it!) In our case, the genetic testing has very much been helpful in explaining why he reacts poorly with side effects due to metabolizing issues with some meds, led us to this new one with few side effects if any, but on flip side, I am not convinced it led us to the one that best eliminates his issues. It has been a helpful tool but not a complete crystal ball. I still would recommend the testing as a road map.

[MrsMapdog in reply to DocdMom]

I'm sorry I wasn't clear enough. The Prestiq was on the list for best depression medicine for me. It listed 5. Prestiq, vibryd, effexor and two others I don't remember. The genetics test then breaks down the best class for antipsychotics, anti anxiety and sleep aids for your genes. I've never seen help from meds for my ocd struggles. I have been on Luvox, Anafranil, Zoloft, Paxil and a few others.

[PsychologyOnions]

I have done the genetic testing and found it helpful. the ssri I went on that the genetic test said would work best has helped significantly more than the others I tried. I also learned from the genetic test that I had an issue with processing folate, so I went on a medical food for that which supposedly also helps with the effectiveness of an ssri. personally, I think it is a good idea because it can take a little bit of the guess work out--although either way, figuring out the correct medication/dosage is a dumb, tedious process. in terms of upping the dose: I did have to go up quite significantly on my ssri, my understanding is that the dosage tends to need to be higher in order to help with ocd.

[Sallyskins]

I can't say much about genetic testing - I haven't had it done and didn't know that it could be done - or if it's actually effective. Picking the right SSRI can be a bit hit and miss.

I should say, though, that SSRI medication isn't a magic bullet that sorts out OCD altogether. Normally high doses are needed for OCD - and a booster in the shape of a low dose of an anti-psychotic such as aripiprazole can be helpful (don't let them prescribe your son sulpiride, though - it leads to serious weight gain).

But medication on its own isn't enough. It's at its most effective in combination with CBT (cognitive behavioural therapy). Medication damps down the OCD, but it takes CBT to really get results with OCD.

[Heartlandgirl]

my daughter had the genetic testing done. I think it is a great tool. Is it expensive? Yes. But it may save you lots of time and trial and error to find a good medication that works for your specific body. And when you are suffering from a mental illness(es), time saved is HUGE! I’d like to add that not only does it tell you what medications work for your specific diagnosis (anxiety, depression, etc) that you would take every day, it also tells you which medications you could possibly need in an emergency that work or don’t work for you, saving you valuable time and pain there, too! And, like someone else said, you find out if you have the MTHFR gene, too, which determines how you process folate. Hope that helps!