(no subject)

[the_rck]

Just got the report for the genetic testing for how I’m affected by psychiatric meds. Apparently it’s not just that I’ve had bad luck with SSRIs and need to try another. I actually shouldn’t be using them at all because I don’t metabolize them right and have a higher risk of side effects than normal. Specifically:

SLC6A4: "This patient is homozygous for the short promoter polymorphism of the serotonin transporter gene. The short promoter allele is reported to decrease expression of the serotonin transporter compared to the homozygous long promoter allele. The patient may have a decreased likelihood of response to selective serotonin reuptake inhibitors due to the presence of the short form of the gene and may benefit from medications with an alternative mechanism of action."

HTR2A: "This individual is homozygous variant for the G allele of the -1438G>A polymorphism for the Serotonin Receptor Type 2A. They carry two copies of the G allele. This genotype has been associated with an increased risk of adverse drug reactions with certain selective serotonin reuptake inhibitors."

I apparently have 'reduced folic acid conversion,' so my psychiatrist wants me to start supplementing that immediately. "This individual is heterozygous for the C677T polymorphism in the MTHFR gene. This genotype is associated with reduced folic acid metabolism, moderately decreased serum folate levels, and moderately increased homocysteine levels."

And there’s something about me being a poor metabolizer of medications that 'go through the CYP2C9 enzyme system' without an actual explanation of what that means. Is that related to the SSRI thing? I can’t actually tell from the report or my doctor’s comments on it. I suppose that’s for Dr Google… Just maybe not today.

There are a couple of medications listed as okay for me that I had huge problems with, specifically Elavil and Effexor. Elavil just dropped my blood pressure from low normal to too low to stand up without something to lean on. Effexor made me actively suicidal and kind of knife obsessed. I only took that for about three days.

Valium (a bad experience) and Ambien (never tried it) are both listed as 'moderate' problems in as much as I’m likely to end up with higher serum levels than most people would. Ativan is listed as fine which, well, if the report had said it was bad, I’d have assumed the report was wrong.

Comments

[lunabee34]

That is really, really interesting. I hadn't realized that sort of info was determined via genetic testing. Cool.

[the_rck]

The test is only sometimes useful because the research really isn't there yet. I got it because I've been trying different medications for nearly thirty years without finding one that works and because Medicare (currently) pays for it 100%. Even if it were vastly accurate, I'd have been very hesitant to pay out of pocket because it's upwards of $3600.

There are things on my no known genetic problems list that I know don't work for me, including some that had pretty nasty side effects. Paxil, the SSRI that had the least side effects for me, is listed as one of the two that are most likely to give me really nasty side effects. All it did was make me fall asleep every time I sat down. Of course, the other medication on that list gave me massive problems.

In another ten years, though, the test might be considerably more accurate. My doctor discussed whether or not I wanted to ask to have my cell samples destroyed after the testing was done. I'd have to call and ask them to do it, but they will. The downside is that I wouldn't contribute to medical research and that my sample wouldn't be available for further testing if the tests improve in the future. On the other hand, if I don't have it destroyed, I have no legal right to tell them what they can and can't do with it.

[lunabee34]

This is just really fascinating to me. I had no idea you could predict drug intolerances from genetic testing. It's so cool how far we've developed in the past two decades on this kind of research.

[brunettepet.livejournal.com]

This is all good to know.

[desdemonaspace]

Your doctor(s) are FAR more thorough than mine are.

[dancingdragon3.livejournal.com]

Wow, I didn't realize that was possible. Way to go for your doctors finding the problem.

[the_rck]

It's still only iffy in terms of reliability (though I'm inclined to assume that, if they tell me something is likely to be bad, the odds are pretty good. Stuff they say is okay just may be absence of evidence due to not yet knowing what to look for.