Personalized Medicine in Psychiatry

Scientists have discovered specific genetic variations that modify the body’s response to certain drugs and therapies. By identifying these variations, clinicians can design a treatment plan optimized for an individual patient. When you apply this technology to mental health, a psychiatrist moves beyond “trial and error” to provide a more rational and personalized approach to treatment. This new development is known as “personalized medicine.”

Personalized medicine has the potential to both increase treatment effectiveness and lower costs across a wide range of medical specialties. Applying this technology to mental health provides a more rational and personalized approach to treatment.

Dr. Buggie is one of only a handful of Manhattan psychiatrists offering personalized medicine through Genomind and their Genecept Assay.

Genomind's Genecept Assay

Genomind's Genecept Assay is a comprehensive, simple to use saliva-based tool for understanding genetic and biological markers that best inform responses to different psychiatric treatments. The Assay is Genomind’s core product. It consists of a proprietary panel of 10 biomarkers, an analytic report, and consultation with a psychopharmacologist. The Assay’s purpose is to help clinicians more quickly find appropriate, effective treatment based on individual patients’ physiological and genetic profile.  Test results are back in 3-5 days.

Genomind's Genecept Assay can be used for patients with a range of difficult to treat psychiatric conditions including depression, bipolar disorder, schizophrenia, anxiety disorders, OCD and ADHD. The Genecept panel biomarkers have been individually selected for actionable clinical applicability to treat neuropsychiatric conditions. The panel is unique for its dual approach; it includes both pharmacokinetic and pharmacodynamic genes. 

The Genecept Assay is covered by most private insurance companies but not government sponsored plans like Medicaid or Medicare.    FAQ

Genecept Assay: 10 Biomarkers

  1. Serotonin Transporter (SLC6A4):  This gene may indicate a reduced ability to move serotonin, making someone less likely to respond to SSRI antidepressants and more likely to experience side effects from these medications related to excess serotonin levels.
  2. Gated Calcium Channel:   Variation in this gene has been associated with multiple psychiatric disorders, including bipolar disease and schizophrenia, although it accounts for only a very small amount of the risk associated with these disorders.
  3. Ankyrin G:   Variation in this gene has been associated with multiple psychiatric disorders, including bipolar disease and schizophrenia, although it accounts for only a very small amount of the risk for these disorders.
  4. Serotonin Receptor (5HT2C):  The serotonin receptor is a molecule that plays an important role in signaling the body that it has had enough food. Newer antipsychotic drugs, which block the activity of serotonin at this receptor may also cause metabolic syndrome (weight gain, diabetes and increased blood pressure and cholesterol).
  5. Dopamine Receptor (DRD2): All antipsychotic drugs bind to this receptor and work by blocking the activity of dopamine in parts of the brain. Certain individuals have a genetic variation that can change the binding attraction of this receptor and lead to worse response with antipsychotic medications.
  6. Catechol Methyl Transferase (COMT):  In certain individuals, COMT activity is higher than average, which can lead to lower levels of dopamine in the frontal lobe. This may have behavioral consequences, such as difficulty with memory and concentration, as well as experiencing symptoms of depression. Other individuals have higher levels of dopamine in their brain because the COMT enzyme doesn’t work as well and doesn’t break dopamine down quickly enough.
  7. Methylenetetrahydrofolate reductase (MTHFR):  MTHFR is an enzyme that helps to convert folic acid to methylfolate, which the body uses to make brain chemicals like serotonin, norepinephrine and dopamine. Having changes in the DNA of the gene that makes MTHFR can lead to various behavior and cognitive problems.
  8. 9. 10. Metabolism (CYP2D6, CYP2C19 and CYP3A4):  Changes in the genes coding for these enzymes can lead to faster or slower breakdown of medications. Therefore, faster breakdown can lead to lower levels of a drug in the body than would be expected, and slower breakdown can lead to higher levels of drug in a body than would be expected.