Genetic Test Helps Target Anxiety Medication

28 year old Thomas from Colorado was first diagnosed with anxiety at age 16 but the construction worker has struggled with medication. He is in a good place now but it’s taken more than a decade….

Starting in 2011 Thomas said the medication at times made him feel worse. “I thought about suicide at one point and here I was being told the medication was going to help me.”

After 3-4 years of his psychiatrist changing doses and changing medications during college, Thomas felt in worse. The side effects alone added up - the drowsiness, slurring words, balance issues and intolerance to eating.

Thomas switched physicians when he was 26 and his new psychiatrist ordered a test called GeneSight that helped figured out the right type of medication for him - the test basically analyzes how a person’s genes might alter or impact how a medication will work. The physician used the test and the lab’s report to make adjustments. The results have helped stabalize Thomas for the first time - “I finally feel present and healthy,” he said, “I can go to work 5 days a way…”

The tests aren’t cheap - costing several hundred dollars - and some who have to pay for them wonder about the cost and benefit. Thomas’s situation is a good example of the benefit given more than a decade of trial and error that cost him several jobs and cost the health system and insurance plans more than $50,000 “if I had to guess” in just script changes and visits. The downside, from an employer’s point of view, is 2-fold: does it work for everyone and do the reports from the tests guide the physician to a decision they could come up with reasonably on their own anyway using clinical judgement? A dozen employer benefits managers question at what point this type of test necessary and whether its cost is worth it early in the diagnostic and treatment process for all patients with anxiety or depression, or those who’ve been struggling for awhile. “I get the importance of guiding the physician and patient to the right options, right away, not only for those with anxiety but also other psychiatric conditions, but there is a broader question of whether the cost is too great and if the dosing changes don’t have an impact,” says Pam Wilton, a medical director for a construction business.