DNA testing to identify best psychiatric drug for patients still uncertain: study
The first week of October is Mental Illness Awareness Week, established in 1990 by the US Congress to raise awareness on mental illness and the various issues surrounding it. According to the World Health Organization (WHO), around 450 million people are currently living with mental or neurological disorders.
In the recent years, genetic testing has entered the playing field when it comes to deciphering correct treatment for a patient with mental illness. However, a recent investigation by the New England Center for Investigative Reporting (NECIR) questions the reliability of these tests, which are currently used by doctors as a guide to prescribing medicine for patients with neuropsychiatric conditions.
NBC News reports that according to NECIR's Beth Daley, "Genetic tests to identify the most effective psychiatry drugs are the hot new thing in the race to create personalized treatments based on people's DNA."
She added, "The take-home is you don't know if they work or not because no one has ever independently checked them out."
Daley's team uncovered that around 600,000 of these genetic tests have been ordered by doctors in the last three years, and these tests were used to find out what treatment would be best for patients with depression, attention deficit disorder, and anxiety. Daley also found that these tests have little oversight for consumer safety, as they currently do not require approval from the U.S. Food and Drug Administration.
A separate article written by Dr. Robert Klitzman, professor of psychiatry and director of the Bioethics Masters and Online Certificate and Course Programs at Columbia University, was recently published in the Journal of Nervous and Mental Disorders, claiming that "Not only polygenetic influences, but life circumstances, and interpersonal and environmental interactions can shape many mental health conditions."
Dr. Jehannine Austin, PhD wrote in the Psychiatric Times in 2013, "No genetic test can predict with certainty who will and who will not become mentally ill. Despite this, there remains considerable value in identifying the genetic variants that increase risk of psychiatric disorders."
However, Dr. Alexander Bystritsky, director of the UCLA Anxiety Disorders Program, who admits to not prescribing these genetic tests due to their "low predictive value at a high cost and [add] additional time" argued that "Genetics should not be a substitute for good clinical assessment and clinical judgment."
Bryan M. Dechairo, the senior vice president for medical affairs and clinical development of Assurex Health, the company behind genetic test GeneSight, told NBC News, "There are multiple factors in how a patient responds, and we can take away a lot of the guessing. A doctor is picking from a smaller list."