Now 34, Anna* has been on and off anti-anxiety medications since she was 21. By the time she met with a new physician three years ago, she felt like she had tried everything. “Every medication I took gave me terrible side effects,” she says. Headaches, nausea, sleep disturbances, low sex drive, and even full-blown panic attacks were part of Anna’s daily life. After a while, she succumbed to the idea that she had to deal with side effects if she didn’t want to have anxiety. “But as I got older and I talked to more people who were also suffering from anxiety,” she says, “I realized that living with those side effects shouldn’t be necessary.”
About 18 percent of adults in the U.S. suffer from anxiety disorders each year, making them the most common form of mental illness. Only 37 percent of those receive treatment, according to the Anxiety & Depression Association of America. For Anna, the problem wasn’t getting treatment but finding one that worked. After her daughter was born, Anna’s symptoms became worse. “I couldn’t continue taking the medication I was on once I became pregnant because it wasn’t safe,” she says.
For a time, hoping to leave behind the medications and their side effects, she tried combating her anxiety by increasing exercise and meditation. But that natural approach only helped a little bit. Eventually, she went back on prescription medication. Once again, the cycle of side effects began. Some days were better than others, but she was never completely free of them, making her feel like she had to accept that this was her version of “normal.”
But that was debilitating. Something as simple as going grocery shopping could bring on a panic attack. In addition, her anxiety was standing in the way of being the best mom she could be to her daughter because it was paralyzing her. She knew she needed to do something—about the anxiety and the side effects she was experiencing.
Over time, Anna became more vocal with her physician about her concerns. “At first, [the doctor] said, ‘I don’t think it’s the medications; I think you’re just too anxious,’” Anna recalls, which only made her feel worse. Finally, when Anna made it clear she wasn’t willing to continue with the current medication or try another one, her physician suggested a genetic test called the GeneSight® test. “I was a little hesitant at first,” says Anna. “But as soon as I learned that the test only required a cheek swab, I was completely comfortable with it.”
The GeneSight test analyzes variations in a patient’s genes to determine how the body may metabolize or respond to certain medications that treat depression, anxiety, ADHD, and other psychiatric disorders. Metabolism is the process by which medications are broken down in the body. The GeneSight test provides your clinician with information about which medications may require dose adjustments, may be less likely to work for you or may have an increased risk of side effects based on your genetic makeup.
“When medications are broken down at faster rates, your body may not accumulate enough to alleviate symptoms,” says Robin Miller, MD, the medical director of Triune Integrative Medicine in Medford, Oregon, who has ordered the GeneSight test for many of her patients over the past seven years. “But if a medication is broken down at a slower rate than normal, you may have too much at any given time, which may lead to side effects.”
The test can be taken in a doctor’s office or self-administered at home, but must be ordered by a healthcare provider who can prescribe medication. The sample is sent to the GeneSight lab for analysis, and test results are sent to the provider in about two days. Many insurance companies will help cover the cost, and 95 percent of patients pay $330 or less for their GeneSight test.
Even with its unique ability to provide insight on how a patient’s body may break down or respond to a specific psychiatric drug, the GeneSight test is not intended to be used solely to determine treatment. “There are so many factors that can affect your mood, and there are so many factors that can affect how medications work,” Dr. Miller says. As an integrative medicine physician, she recommends a holistic approach to finding the best treatment. “I try to get my patients to clean up their diet and exercise, and I talk about the benefits of cognitive behavioral therapy, where they can discuss past experiences and traumas that can affect anxiety and depression,” she explains. She considers the GeneSight test to be one part of figuring out an overall treatment plan.
Interpreting Results
Once your doctor receives the test results, medications are placed into one of three categories: Red for significant gene-drug interactions; yellow for moderate gene-drug interactions; and green for medications that the body is expected to metabolize or respond to normally based on a patient’s genetics.
According to her results, Anna’s body metabolizes certain psychiatric medications slowly, causing horrible side effects. “Receiving reassurance that [the side effects were a result of] how my own body was reacting [and metabolizing] and not my anxiety made me feel so much better,” she says. “I thought I was being difficult, or I was strange and the anxiety was getting the best of me. I did not realize it had to do with my body.” The test revealed that the two medications in her green category were ones she’d never taken before.
Within two weeks of being on the new medication, her side effects were gone. “I felt instant gratification and relief knowing I had found something that will work for me,” Anna says.
“The GeneSight test has changed how I view medicine,” she says. “I used to feel like a guinea pig, and that [my doctors] were just kind of guessing. This sort of tool can really help guide them. It’s so beneficial for everyone, for doctors as well as patients—especially, anyone nervous to put anything in their body. I wish I had known about it a long time ago and I tell so many people now.”
Today Anna finds her anxiety is much more manageable. “I used to have panic and anxiety attacks every day at work and when I was with my daughter out in public, but now it’s very rare that I have one,” she says. “I’m a lot more laid back, less on edge, and more of a people person.” With a clearer understanding of how her body processes and responds to certain medications, Anna’s no longer worried about her future—and that’s a huge relief.
*To protect her privacy, only the patient’s first name was used in this story.
The GeneSight test must be ordered by and used only in consultation with a healthcare provider who can prescribe medications. Do not make any changes to your current medications or dosing without consulting your healthcare provider. As with all genetic tests, the GeneSight test results have limitations and do not constitute medical advice. The test results are designed to be just one part of a larger, complete patient assessment, which would include proper diagnosis and consideration of your medical history, other medications you may be taking, your family history, and other factors.