Sandra Hanna
Pharmacist, Personalized Prescribing Inc.
With pharmacogenomic testing, pharmacists can help identify the right medication for a patient based on their DNA.
The concept of bio-individuality has taken off in the world of nutrition. The idea is that there’s no one-size-fits-all approach to health, and that we’re all unique in our biological makeup and requirements. A lot of bio-individuality has to do with genomics — our personal DNA. This concept goes beyond nutrition, and it’s now being applied to medicine, too, thanks to the science of pharmacogenomics.
“Pharmacogenomics is the study of how DNA relates to medication response,” says Sandra Hanna, a pharmacist at Personalized Prescribing Inc., a consumer pharmacogenomic testing company. By testing and analyzing patients’ DNA, the organization helps determine which medication would work best for people based on their unique genetic makeup.
Going beyond traditional mental illness medication prescribing
“At Personalized Prescribing Inc., we focus on how people’s genetics or DNA relates to anti-depressant response in particular,” says Hanna.
If a doctor diagnoses someone with depression or anxiety, a selective serotonin reuptake inhibitor (SSRI) is generally the first-line treatment. However, there are many first-line SSRIs and patients’ responses to SSRIs vary widely. Part of the reason for this is due to their unique genetic makeup. Genetic factors influence how our bodies respond to drugs, and this includes differences in how we metabolize them.
“The majority of anti-depressant medications are cleared predominantly by two different liver enzymes, so we test those enzymes,” explains Hanna. “Some people have poor clearance, so they accumulate the medication in their bloodstream. For these patients, we may recommend a dose reduction. Other people are ultra-rapid metabolizers, so they clear the medication so fast that it doesn’t reach the brain in sufficient enough concentrations to be effective. We may recommend an alternative drug for these patients.” These recommendations are evidence based, and backed by the FDA or other relevant guideline.
I see this being a mainstay in health care in the future because it improves patients’ quality of life, it saves lives, and it saves everyone money.
Personalized recommendations and prescriptions
Metabolism is well-studied and understood, but Personalized Prescribing Inc. takes things a step further by testing pharmacodynamic genes — in this case, brain receptor genes. “We test the capacity for an anti-depressant medication to actually enter the brain via the blood-brain barrier,” says Hanna. “We also test the different genetic expression of the relevant serotonin or dopamine receptor genes to see if they can effectively be blocked or agonized as necessary in order to create the desired therapeutic response.”
Combining DNA testing with the personalized analysis and evidence-based recommendations from its team of in-house pharmacists, Personalized Prescribing Inc. is helping to take the guesswork out of prescribing. By helping doctors and patients to identify the optimal medication or dosage, it’s delivering the next frontier of medicine — personalized and tailored medicine, which increases the efficacy of medications and reduces negative side effects.
“I see this being a mainstay in health care in the future because it improves patients’ quality of life, it saves lives, and it saves everyone money,” says Hanna.
