There is a new frontier in the world of psychiatric care—DNA testing. How does DNA testing apply to the world of psychiatry and what effect might it have on your own treatment plan?

DNA testing can give you and your doctor a better idea of which medications might work better for you, allowing you to develop a more effective treatment plan.

How DNA Testing Works in Psychiatry

Medication in the world of psychiatry often involves a good deal of trial and error. Patient and doctor work in partnership in medication management to determine how well a medication is working. This involves checking in on a regular basis. The analysis in these scenarios also often depends on anecdote and patient experience, making it an inexact science.

Genetic testing provides more information to help guide this process. Through DNA testing, a doctor can assess several factors that may affect a patient’s experience with a medication, including:

• How your genes may affect your benefit from medication
• How quickly your liver metabolizes a medication
• The likelihood you may experience certain side effects on a drug

This provides both you and your doctor with additional information when deciding on specific medications or doses, giving a clearer and more informed path forward.

Pharmacogenomic testing like this, however, is not the end all and be all in psychiatry. A doctor must still carefully assess a patient’s history and symptoms when prescribing medication.

Testing can provide important clues along the way, however, and help streamline the process of medication management. It can also be helpful for patients who are having trouble finding an effective medication or for whom side effects have been an ongoing issue.

Why doesn’t DNA Testing include Esketamine?

There is one major treatment, however, that is not included on the psychotropic panel that results from this type of DNA testing—esketamine. Esketamine-based nasal spray has been making a significant impact on treatment of depression, specifically treatment-resistant depression. Why is this important medication not included in the DNA testing panels?

Well, it relates to how esketamine interacts with the body and the brain. Esketamine delivers such fast results because it directly impacts the frontal cortex and a neurotransmitter known as glutamate. It does not follow the traditional direct serotonin or dopamine route that many oral antidepressants do, as a result. Because it is delivered intranasally, it bypasses the liver’s “first pass metabolism” measured in DNA testing that affects the blood levels of many oral antidepressants.

How to talk to your Physician about Esketamine

While esketamine is not now and may not be a part of DNA testing for a good while, it is still an effective remedy for many types of depression. If you are experiencing signs of treatment-resistant depression or a major depressive disorder, Spravato® may be of great help. Discuss whether esketamine is the right answer for you with your provider. They will be able to walk you through the pros and cons and help you determine whether Spravato could work for you, even without genetic testing.

If you would like to learn more about the benefits of DNA testing or esketamine in the treatment of depression, get in touch with your primary care provider or psychiatrist for recommendations. Relief from symptoms is within reach with either of these medical advancements.