Dr. James Kennedy
Head, Molecular Science and Tanenbaum Centre for Pharmacogenetics, Campbell Family Mental Health Research Institute, CAMH
Pharmacogenomic medicine uses DNA to determine the best medication for a given patient. From a simple cheek swab, DNA is purified, sequenced, and analyzed using a proprietary algorithm. The resulting report communicates the medications that are most likely to elicit adverse side effects in each patient. Physicians may use this information to guide their treatment decisions with prescribing medications. Patients may use this information to better understand their own genetic makeup and become more informed agents of their care.
Pharmacogenomic testing has significant implications for psychiatry. Many patients with mental illness independently discontinue their medication trials due to experience of adverse side effects, such as severe changes in weight, or lack of response. Through pharmacogenomic testing and corresponding prescription changes, patients are more likely to respond, and less likely to experience side effects. Scientists and physicians hope that this will encourage patients to adhere to their prescribed medications according to their physician’s guidance, thereby improving the likelihood of long-term remission and recovery. The application of pharmacogenomics in psychiatry has been researched most commonly in patient populations with major depressive disorder for whom at least two prescribed medications have not led to improvements. In recent years, scientists have begun to explore applications of this testing to support treatment of other mental illnesses, such as bipolar disorder and schizophrenia. For example, at the Centre for Addiction and Mental Health (CAMH), a recent study offered pharmacogenomic testing to 11,000+ patients with mental illness across the province of Ontario. hough the study in its previous form has ended, data analysis continues at the Kennedy lab in the Tanenbaum Centre for Pharmacogenetics. The lab also has several ongoing studies regarding the application of pharmacogenomic testing for illnesses such as opioid dependence, sleep disorders, post-traumatic stress disorder, and schizophrenia.
Currently, access to these tests for the guidance of psychiatric treatment is unstandardized. However, evidence exists for significant cost-savings associated with adoption of pharmacogenomic testing in healthcare payment plans. As such, further research into the use of pharmacogenomic testing and investments in this innovation should facilitate universal access and enable additional research breakthroughs for the treatment of all mental illnesses.
