3 ms·

Hey there. I have a personal interest in genetic testing for mental health, the goal being to help psychiatrists make the decision about which anti-depressant t

by rms 17y ago

Hey there. I have a personal interest in genetic testing for mental health, the goal being to help psychiatrists make the decision about which anti-depressant to try first. The conclusion was the 5-HTT gene was the only one mutation where the research was verified enough to have a chance of being used right now, and that gene doesn't help make any treatment decisions. I think it'll be at least 10 years before mental health genetic testing becomes mandated by insurance, though maybe faster if improve outcomes can be readily demonstrated. I think one of the main consequences is that NRIs are going to be more widely prescribed than they are right now, because of mutated BDNF genes. http://jama.ama-assn.org/cgi/content/full/296/13/1609?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Hyeran+Kim&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT http://jama.ama-assn.org/cgi/content/full/296/13/1609?maxtos... I of course agree with you about the presence of doctors in these processes. Genetic testing is only really meaningful when interpreted by the doctors in the context of all of the other important information.

phren0logy 17y ago
Awesome. I don't mean to imply that I'm not excited about the promise of genetic testing for mental health. I'm just frustrated about the direct marketing of tests with dubious value to make a fast buck off of vulnerable patients.
- rms 17y ago
  Can you send me an email or post your email address in the profile? I'd like to know what demonstrated validity you would need before using a genetic test to help make medication decisions. Right now I could bundle and sell a panel of genetic tests (Costing somewhere between $199 and $499 based on market research) to help psychiatrists make a decision about the first medication to try, but most of the research is one-off studies in limited populations. The 5-HTT one is the only one that's been well replicated; people with the right 5-HTT polymorphism respond to SSRIs.
  - phren0logy 17y ago
    I'd need Positive and Negative Likelihood Ratios published in a peer-reviewed publication gathered from a population similar to the one I was treating. Preferably multi-site, and with replication of results by another independent research group.

by rms 17y ago

phren0logy 17y ago

Awesome. I don't mean to imply that I'm not excited about the promise of genetic testing for mental health. I'm just frustrated about the direct marketing of tests with dubious value to make a fast buck off of vulnerable patients.

rms 17y ago
Can you send me an email or post your email address in the profile? I'd like to know what demonstrated validity you would need before using a genetic test to help make medication decisions. Right now I could bundle and sell a panel of genetic tests (Costing somewhere between $199 and $499 based on market research) to help psychiatrists make a decision about the first medication to try, but most of the research is one-off studies in limited populations. The 5-HTT one is the only one that's been well replicated; people with the right 5-HTT polymorphism respond to SSRIs.
- phren0logy 17y ago
  I'd need Positive and Negative Likelihood Ratios published in a peer-reviewed publication gathered from a population similar to the one I was treating. Preferably multi-site, and with replication of results by another independent research group.