The Gene-Guided Path to Better Mental Health

Genetic testing is revolutionizing mental health treatment by eliminating the frustrating guesswork that has long defined medication selection for anxiety and depression. We dive deep into this game-changing approach that's giving patients and providers a scientific edge in finding effective treatments faster.

For generations, treating anxiety and depression has meant months or years of trial and error – trying one medication after another while patients suffer through side effects and continued symptoms. GeneSight testing changes everything by analyzing your DNA to determine which medications your body will likely respond to best. Through a simple at-home cheek swab, this pharmacogenomic test creates a personalized medication map that categorizes antidepressants, anxiolytics, and other psychiatric medications into green (likely effective), yellow (may work), and red (likely problematic) categories.

The test's impact can be profound, especially for those who've struggled for years to find effective treatment. We share personal experiences with the testing, including a family member who had tried countless medications and even electroconvulsive therapy before discovering through testing why so many medications had failed. What makes this approach particularly valuable is that your DNA doesn't change – making this a one-time test with lifetime benefits. At approximately $300 for those without insurance coverage (though many plans do cover it), it's an investment that can save countless months of medication trials. Ready to explore whether genetic testing could help guide your mental health treatment? Reach out to us at Hamilton Telehealth to discuss how this breakthrough approach might benefit you.

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Chapters

• 0:16 Welcome and Legal Disclaimer
• 0:48 Introduction to Genetic Testing
• 1:57 How GeneSight Works
• 4:28 Benefits for Treatment Planning
• 7:22 Personal Experiences with Testing
• 10:10 Test Accessibility and Insurance Coverage
• 12:41 Final Thoughts and Contact Information

Transcript

Kelli: 0:16

Hey everybody, welcome back to another episode of Tattoos and Telehealth. I'm Kelli White with Chari Health, and this is my dear colleague, Nicole Baldwin, and we have something really exciting that we want to chat with you guys about. First, our lawyers make us say this is by no means considered medical advice. This conversation is just between two gals chatting it up about some things that we know, don't know, want to know more about, and so this conversation does not indicate a patient provider relationship in any way, form or fashion, and we just want to visit with you about some things that we know or want to know more about.

Kelli: 0:48

And something that is kind of new ish, but I don't know if you guys know about this, but there is genetic testing available for anxiety and depression markers. Now hear me out, this isn't a genetic testing that says, yes, you have anxiety and depression. That's not what this is about. This is a genetic test that lets clinicians guide their therapy toward medications that you may or may not be more susceptible to benefit from or not benefit from. So I'm going to let Nicole kind of take over and talk to you about that a little bit more.

Kelli: 1:25

So it makes better sense, but it's really exciting for us because as clinicians, for years we have used the trial and error method. In other words, a patient comes to us with anxiety and or depression and we have to just like well, you know, we've had good luck with this one, let's start with this one. And then you come back and we do this whole thing where it's just trial and error. But there is a company that does genetic testing and it lets us know which medications you might benefit from over others. So Nicole has done this test. So, Nicole, tell us what happened when you took the test.

Nicole: 1:57

So I found out that GeneSight is the name of the company and it's a pharmacogenomic test, right, and they. What they do is they send you a swab. It's a you have to have a provider order. You have to have a healthcare provider write the order. They ship it to your home. Insurance can be filled out for them to run it through your insurance. Swab your cheek, send it back. You do it all from home and it will come back and give you green, yellow and red. So I wanted to do it because I'm like, hey, you know, let's just see what this is all about, let me see how, like you know how this works. And so I swabbed my cheek, I sent it back. Within a couple of weeks I got the results back and what it does is it tells you for antidepressants. It tells you what's in the green, what's going to work best for your DNA, yellow, what's going to what's maybe, maybe not, and then what's in red, that's, you're likely going to have a side effect. And so this is gives us direction on where to start for you. So, as of you know history, historically, when a patient comes in and they having symptoms of anxiety and depression, we diagnose them based on whatever factors. Um, we typically pick an antidepressant that works well with your symptoms, but there's many, so we pick one and then you have to be on it for four, six, eight weeks before you may see a result. And then then are we changing the dose, are we changing the med? And if it's not one for you, then you stop it, you start another one. We go through the same six to eight weeks. So some patients. It's very frustrating for patients and for providers that we're trying to help you, but these medications typically take so long to figure out if they're, if they work for you or not, and then, if it doesn't, you got to start the whole cycle over. So it is not uncommon for patients to wait two months, three months, six months, a year, two years, going through different medications to figure out what works for you and what regimen, because a lot of patients need more than one medication and you need to match two medications that are going to be good for the patient. And you need to match two medications that are going to be good for the patient. So for my test for my antidepressants, it gave me like it gives me like 12 that are green. It gives me three that came back yellow, and then one that came back where I'm probably going to have side effects. And it's not a hard test answer but it's a guide that guides us to tell us where to start for patients and where you're going to have the best likelihood of it working. And so, this is amazing it cuts down the trial and error time significantly. It does.

Nicole: 4:37

Antidepressants for non-smokers, antidepressants for smokers, anoxalytics and hypnotics so things like these are mostly controlled. But things like Xanax, valium, lunesta, ambien those are all controlled substances, but what it's useful for is typically is SSRIs and SNRIs like the venlafaxine, the sertraline, the Zoloft, the Wellbutrin, things like that. So that's what it's really good for. But it also goes into antipsychotics as well as mood stabilizers, and so it gives us tons of information and just information on what is going to work best for our patients in the most likely. Now I have a family member of mine who has struggled with anxiety and depression her whole life. She has been on, I swear, everything under the sun, even had the electro therapy, um, about 10 years ago, where they shock your brain or whatever, they shock your brain or whatever, and she, I ran hers and she only had like a couple of green and a lot of red. So for me, it was a lot of green, a little red.

Nicole: 5:54

Hers was definitely the other way, and I most patients have a mix of green, yellow and red, and so this takes the guesswork, a lot of a lot of the guesswork out, um, of where to start patients on anxiety and depression medications, and so it's a real big game changer for those that are struggling with it and you said they take insurance to do this test right?

Nicole: 6:19

Oh, they do. They do Even Medicare Medicaid. When I go in and order for a patient, it asks me if they have state insurance, medicare Medicaid or I don't know, and then it says, if I say no, it'll say what type of insurance and I can either enter it in if I have it, or I can click send to the patient and it'll send the patient information name, group number, blah, blah, blah, blah, blah and it will be submitted to your insurance. So we attach to it a diagnosis code if you've been diagnosed with anxiety, depression, panic disorder, whatever that is, and then from there the diagnosis code will help with insurance approval.

Kelli: 6:59

So yeah, I saw ADHD meds on there, didn't I? So even even things like ADHD, some medications we use for obsessive compulsive disorder. Those meds were on there as well.

Nicole: 7:10

Yep, yep. So the, the stimulants, the non-stimulants, things like that Yep, absolutely, and that's all on there as well, just to kind of give us a guide on what's gonna, what's going to be best Huffle. I met up with a patient a couple of weeks ago and I started her on a medication. But I said, if this doesn't work, we probably should try this genetic testing to see where to go, because she really has a lot of panic. And I said, if this doesn't work, let's go ahead and order the test. And she's like, can we just order the test? And I'm like, absolutely, I'm going to start you on this med. So we were already starting therapy somewhere in the meantime. I'm going to get this test shipped to you. So she swabbed and she sent it back. So we're waiting on results. So it has been great, um, and I I'm eagerly awaiting her results to kind of see you know if it's, you know if this medication is going to work well for her, or if we need to switch it or you know, whatever the case may be.

Kelli: 8:08

So yeah, so I'm super, super excited about it and, you know, one of the other things that I want to point out is the two different styles of information that it comes back. So smoking and non-smoking and that's very important because of the way that our body responds to medications when we are doing something that causes our cells to bind with other things. So it's important that we keep that in mind. So, if you have any other health conditions not just smoking, but if you have gut issues, if you have autoimmune diseases, if you take other medications, if you have illnesses, if you I mean anything else there's a ton of other things going on with your person that could affect this test as well.

Kelli: 8:42

So just keep in mind, guys, this is just a tool that us, as providers, can put in our toolbox, but it's a huge tool. It's a giant breakthrough with us, just because we've always had to do the test and repeat test and repeat cycle of meds, and now we have something that gives us a place to start of meds. And now we have something that gives us a place to start. But just be sure to understand that all of those little things that you do and on everything about your health also goes into place. So be sure that you're upfront and honest with your clinician about every single thing that you do and everything that's going on with your person, because that affects medications as well and doses of medications kind of where we start you on that tree of dosing.

Nicole: 9:23

Because not only you're you're at. You're absolutely right, because not only with starting a medication, but what other meds are you on that are contraindicated? And that's not in this test, right? We have to consider so many things. We have to consider the medications that you're currently on, maybe things that you've tried in the past, but the good news is is that this test you only have to run it once because your DNA is your DNA.

Nicole: 9:45

So you, you know, if you see a new provider in 10 years, 20 years, 30 years, you can take this with you because it's still going to be applicable to you. And so that's the beauty of this. And I think the cash pay for this is around $300 if you don't have insurance, but it is so worth it. When you have anxiety and depression and you're struggling to figure out which med is going to work, which med is going to cause bad side effects, it's just amazing. I mean, the trial and error method has been going on since mankind and now to have something to help us with our direction, it's absolutely just a big breakthrough. So you do need an order from a provider, so you can either come see me, hamiltontelehealth. com, you can see Kelli, you order them as well, correct?

Kelli: 10:33

I do, and you can come see me at charihealthcom, c-h-a-r-i healthcom. And what is the turnaround time for these tests?

Nicole: 10:39

Nicole, it's typically about two weeks. So I get it ordered, it's to you within about four to five days, weather permitting, and then, however long it takes you to swab and enter, you know, put everything in the thing and drop it back in the mailbox, typically about two weeks from there. So much faster than trying a medication and figuring it out.

Kelli: 10:58

So you know, and not much of an emotional roller coaster. I love it, it is.

Nicole: 11:03

It's emotional roller coaster for me because I'm no stranger to anxiety and so I can definitely appreciate this type of study. I wish you know this study was out, you know, 20 years ago. You know, when I started , after I had my daughter, I had really really weird anxiety. Like I'm super outgoing and super like never met a stranger. But this thing, this panic, started coming on in when I would be out and it was. It was terrifying. But getting on the right anxiety medication at that point in my life was it was trial and error.

Kelli: 11:37

So so, yeah, I'm excited for the test, I'm excited to see how it works, moving forward with patients, and I just think it's a great opportunity for us to have a new tool in our toolbox, and it's going to be a powerful one for sure. No-transcript functionality, so once you kind of already know what your DNA sequence looks like, there's a lot of other medications that can be adjusted if your provider is savvy enough with those things. So it's a really good test. It's a really, really good test because you know if you're like a CYP 450A or if you have, I mean like that means something to us. But if you have those genetic markers, that means a lot when it comes to certain medications. So it's just an all around great test to know, a great test to have in your back pocket. And, like Nicole said, it doesn't change your DNA is your DNA. So it's a one-time pop fee. You keep that in your back pocket forever and ever. Amen. And it's going to be. It's going to be with you to help out from here on.

Nicole: 12:56

Yeah, for sure, for sure. So that's. We just wanted to get the word out about this and, um, you know, let you guys know. If you want the test, just let us know, reach out to us, um, and that's really all we wanted to go over today.

Nicole: 13:15

You can find me at hamilton telehealth. com and you can find Kelli at Chari health. com, C H A R I health. com, and we look forward to seeing you guys.

Nicole: 13:21

Yep, nice seeing you guys. We'll see you next time.