The Gene-Guided Path to Better Mental Health

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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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Episode Transcript

Kelli (00:16):
Hey everybody, welcome back to another episode of
Tattoos and Telehealth.
I'm Kelli White with ChariHealth, and this is my dear
colleague, Nicole Baldwin, andwe have something really
exciting that we want to chatwith you guys about.
First, our lawyers make us saythis is by no means considered
medical advice.
This conversation is justbetween two gals chatting it up
about some things that we know,don't know, want to know more

(00:38):
about, and so this conversationdoes not indicate a patient
provider relationship in any way, form or fashion, and we just
want to visit with you aboutsome things that we know or want
to know more about.
And something that is kind ofnew ish, but I don't know if you
guys know about this, but thereis genetic testing available

(00:59):
for anxiety and depressionmarkers.
Now hear me out, this isn't agenetic testing that says, yes,
you have anxiety and depression.
That's not what this is about.
This is a genetic test thatlets clinicians guide their
therapy toward medications thatyou may or may not be more
susceptible to benefit from ornot benefit from.

(01:21):
So I'm going to let Nicole kindof take over and talk to you
about that a little bit more.
So it makes better sense, butit's really exciting for us
because as clinicians, for yearswe have used the trial and
error method.
In other words, a patient comesto us with anxiety and or
depression and we have to justlike well, you know, we've had
good luck with this one, let'sstart with this one.
And then you come back and wedo this whole thing where it's

(01:43):
just trial and error.
But there is a company thatdoes genetic testing and it lets
us know which medications youmight benefit from over others.
So Nicole has done this test.
So, Nicole, tell us whathappened when you took the test.

Nicole (01:57):
So I found out that GeneSight is the name of the
company and it's apharmacogenomic test, right, and
they.
What they do is they send you aswab.
It's a you have to have aprovider order.
You have to have a healthcareprovider write the order.
They ship it to your home.
Insurance can be filled out forthem to run it through your

(02:18):
insurance.
Swab your cheek, send it back.
You do it all from home and itwill come back and give you
green, yellow and red.
So I wanted to do it becauseI'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, Isent it back.
Within a couple of weeks I gotthe results back and what it

(02:40):
does is it tells you forantidepressants.
It tells you what's in thegreen, what's going to work best
for your DNA, yellow, what'sgoing 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 usdirection on where to start for
you.
So, as of you know history,historically, when a patient

(03:02):
comes in and they havingsymptoms of anxiety and
depression, we diagnose thembased on whatever factors.
Um, we typically pick anantidepressant that works well
with your symptoms, but there'smany, so we pick one and then
you have to be on it for four,six, eight weeks before you may
see a result.

(03:22):
And then then are we changingthe 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 toeight weeks.
So some patients.
It's very frustrating forpatients and for providers that
we're trying to help you, butthese medications typically take
so long to figure out ifthey're, if they work for you or

(03:43):
not, and then, if it doesn't,you got to start the whole cycle
over.
So it is not uncommon forpatients to wait two months,
three months, six months, a year, two years, going through
different medications to figureout what works for you and what
regimen, because a lot ofpatients need more than one
medication and you need to matchtwo medications that are going
to be good for the patient.

(04:04):
And you need to match twomedications that are going to be
good for the patient.
So for my test for myantidepressants, it gave me like
it gives me like 12 that aregreen.
It gives me three that cameback yellow, and then one that
came back where I'm probablygoing to have side effects.
And it's not a hard test answerbut it's a guide that guides us
to tell us where to start forpatients and where you're going

(04:25):
to have the best likelihood ofit working.
And so, this is amazing it cutsdown the trial and error time
significantly.
It does.
Antidepressants for non-smokers,antidepressants for smokers,
anoxalytics and hypnotics sothings like these are mostly

(04:47):
controlled.
But things like Xanax, valium,lunesta, ambien those are all
controlled substances, but whatit's useful for is typically is
SSRIs and SNRIs like thevenlafaxine, the sertraline, the
Zoloft, the Wellbutrin, thingslike that.

(05:07):
So that's what it's really goodfor.
But it also goes intoantipsychotics as well as mood
stabilizers, and so it gives ustons of information and just
information on what is going towork best for our patients in
the most likely.
Now I have a family member ofmine who has struggled with

(05:29):
anxiety and depression her wholelife.
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 hersand she only had like a couple
of green and a lot of red.

(05:50):
So for me, it was a lot ofgreen, a little red.
Hers was definitely the otherway, 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 guessworkout, um, of where to start
patients on anxiety anddepression medications, and so

(06:12):
it's a real big game changer forthose that are struggling with
it and you said they takeinsurance to do this test right?
Oh, they do.
They do Even Medicare Medicaid.
When I go in and order for apatient, it asks me if they have
state insurance, medicareMedicaid or I don't know, and
then it says, if I say no, it'llsay what type of insurance and

(06:33):
I can either enter it in if Ihave it, or I can click send to
the patient and it'll send thepatient information name, group
number, blah, blah, blah, blah,blah and it will be submitted to
your insurance.
So we attach to it a diagnosiscode if you've been diagnosed
with anxiety, depression, panicdisorder, whatever that is, and

(06:53):
then from there the diagnosiscode will help with insurance
approval.

Kelli (06:59):
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 aswell.

Nicole (07:10):
Yep, yep.
So the, the stimulants, thenon-stimulants, things like that
Yep, absolutely, and that's allon there as well, just to kind
of give us a guide on what'sgonna, what's going to be best
Huffle.
I met up with a patient acouple of weeks ago and I
started her on a medication.
But I said, if this doesn'twork, we probably should try
this genetic testing to seewhere to go, because she really

(07:32):
has a lot of panic.
And I said, if this doesn'twork, let's go ahead and order
the test.
And she's like, can we justorder the test?
And I'm like, absolutely, I'mgoing to start you on this med.
So we were already startingtherapy somewhere in the
meantime.
I'm going to get this testshipped to you.
So she swabbed and she sent itback.
So we're waiting on results.
So it has been great, um, and II'm eagerly awaiting her

(07:54):
results to kind of see you knowif it's, you know if this
medication is going to work wellfor her, or if we need to
switch it or you know, whateverthe case may be.

Kelli (08:08):
So yeah, so I'm super, super excited about it and, you
know, one of the other thingsthat I want to point out is the
two different styles ofinformation that it comes back.
So smoking and non-smoking andthat's very important because of
the way that our body respondsto medications when we are doing
something that causes our cellsto bind with other things.
So it's important that we keepthat in mind.
So, if you have any otherhealth conditions not just

(08:31):
smoking, but if you have gutissues, if you have autoimmune
diseases, if you take othermedications, if you have
illnesses, if you I meananything else there's a ton of
other things going on with yourperson that could affect this
test as well.
So just keep in mind, guys, thisis just a tool that us, as
providers, can put in ourtoolbox, but it's a huge tool.
It's a giant breakthrough withus, just because we've always

(08:53):
had to do the test and repeattest and repeat cycle of meds,
and now we have something thatgives us a place to start of
meds.
And now we have something thatgives us a place to start.
But just be sure to understandthat all of those little things
that you do and on everythingabout your health also goes into
place.
So be sure that you're upfrontand honest with your clinician
about every single thing thatyou do and everything that's

(09:16):
going on with your person,because that affects medications
as well and doses ofmedications kind of where we
start you on that tree of dosing.

Nicole (09:23):
Because not only you're you're at.
You're absolutely right,because not only with starting a
medication, but what other medsare you on that are
contraindicated?
And that's not in this test,right?
We have to consider so manythings.
We have to consider themedications that you're
currently on, maybe things thatyou've tried in the past, but
the good news is is that thistest you only have to run it

(09:43):
once because your DNA is yourDNA.
So you, you know, if you see anew provider in 10 years, 20
years, 30 years, you can takethis with you because it's still
going to be applicable to you.
And so that's the beauty ofthis.
And I think the cash pay forthis is around $300 if you don't
have insurance, but it is soworth it.
When you have anxiety anddepression and you're struggling

(10:04):
to figure out which med isgoing to work, which med is
going to cause bad side effects,it's just amazing.
I mean, the trial and errormethod has been going on since
mankind and now to havesomething to help us with our
direction, it's absolutely justa big breakthrough.
So you do need an order from aprovider, so you can either come

(10:27):
see me, hamiltontelehealth.
com, you can see Kelli, youorder 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 timefor these tests?

Nicole (10:39):
Nicole, it's typically about two weeks.
So I get it ordered, it's toyou within about four to five
days, weather permitting, andthen, however long it takes you
to swab and enter, you know, puteverything in the thing and
drop it back in the mailbox,typically about two weeks from
there.
So much faster than trying amedication 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 candefinitely appreciate this type
of study.
I wish you know this study wasout, 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 andsuper like never met a stranger.

(11:26):
But this thing, this panic,started coming on in when I
would be out and it was.
It was terrifying.
But getting on the rightanxiety medication at that point
in my life was it was trial anderror.

Kelli (11:37):
So so, yeah, I'm excited for the test, I'm excited to see
how it works, moving forwardwith patients, and I just think
it's a great opportunity for usto have a new tool in our
toolbox, and it's going to be apowerful one for sure.
No-transcript functionality, soonce you kind of already know

(12:19):
what your DNA sequence lookslike, there's a lot of other
medications that can be adjustedif your provider is savvy
enough with those things.
So it's a really good test.
It's a really, really good testbecause you know if you're like
a CYP 450A or if you have, Imean like that means something
to us.
But if you have those geneticmarkers, that means a lot when
it comes to certain medications.
So it's just an all aroundgreat test to know, a great test

(12:49):
to have in your back pocket.
And, like Nicole said, itdoesn't change your DNA is your
DNA.
So it's a one-time pop fee.
You keep that in your backpocket forever and ever.
Amen.
And it's going to be.
It's going to be with you tohelp out from here on.

Nicole (12:56):
Yeah, for sure, for sure .
So that's.
We just wanted to get the wordout about this and, um, you know
, let you guys know.
If you want the test, just letus know, reach out to us, um,
and that's really all we wantedto go over today.
You can find me at hamiltontelehealth.

(13:16):
com and you can find Kelli atChari health.
com, C H A R I health.
com, and we look forward toseeing you guys.
Yep, nice seeing you guys.
We'll see you next time.