Making each decision count
Many patients in eastern North Carolina have waited a long time to see a psychiatric provider, and some have cycled through several medicines with little success along the way. When appointments are hard to come by, trial and error is especially costly. GeneSight, a test from Myriad Genetics, gives your provider information about how your genes may affect your response to many psychiatric medicines, so the next choice can be better informed.
What is tested
A painless cheek swab is analyzed for variations in genes that influence how medicines are processed and how people respond. Two of the most important are CYP2D6 and CYP2C19, which code for liver enzymes that break down many antidepressants and other psychiatric medicines. The report sorts common medicines into categories, from use as directed to moderate or significant gene-drug interaction.
Who benefits most
Testing tends to be most helpful when someone has tried two or more medicines for depression or anxiety without success, has experienced strong side effects at standard doses, or takes multiple medicines for conditions like diabetes, high blood pressure, or heart disease, where interactions are a concern. For people starting their first medicine, standard choices often work well without testing.
What the evidence shows
Research is promising but has limits. In the GUIDED trial, patients whose providers used GeneSight results had higher rates of response and remission, although the trial did not reach its primary goal for overall symptom improvement. Expert pharmacogenetics guidelines support adjusting certain SSRIs and other medicines based on CYP2D6 and CYP2C19 results. Testing informs decisions; it does not guarantee outcomes.
What it does not do
GeneSight does not diagnose depression or any other condition, and it does not predict with certainty which medicine will work. Your symptoms, medical history, other medicines, and preferences remain central. Your provider interprets results alongside a full psychiatric evaluation.
Pharmaceutical science in Greenville
Greenville is home to major pharmaceutical manufacturing and a medical school, and many patients work in science or healthcare. They often ask thoughtful questions about how genetic testing works and how reliable it is. Your provider is glad to go into as much detail as you want.
The process
- You and your provider decide whether testing is likely to change your plan
- A cheek swab is collected during a visit
- The sample is analyzed by the lab
- Your provider reviews the report with you and explains how it affects your options
Results that last
Because your genes do not change, results can inform future medication decisions as well. They become part of your medical record, and with your permission they can be shared with your other doctors.
A real-life example
Picture a nurse who had stomach upset and a racing heart on two different antidepressants, both at starting doses. Her report might show that she breaks down certain medicines very slowly, so normal doses build up higher than expected. Her provider could choose a medicine processed by a different pathway or start lower and go slower. The report does not choose for her, but it explains the past and shapes the next step.
When to wait on testing
If you have tried only one medicine, and only for a week or two, a full trial at a proper dose usually comes first. Testing is most valuable when your history shows a clear pattern of failures or side effects, or when you take many medicines for heart, diabetes, or other conditions. Your provider will tell you honestly whether it is likely to change your plan.
Questions to bring
Ask your provider which medicines are being considered next, how the results could change that choice, and whether your family history suggests genetics may be involved. If a parent or sibling did especially well or poorly on a medicine, mention it.
Getting started
Testing is ordered as part of your care with us and continues through medication management. Visit us at 204 E Arlington Blvd in Greenville. Become a patient to ask whether it is right for you.
Why Choose Eastern Carolina Psychiatry and Mental Health?
- Providers across Greenville and eastern North Carolina who actually listen and take their time
- Now accepting new patients because waiting makes everything harder
- We accept most major insurance, Medicaid, and Medicare — and work with you on costs
- A practice that treats you like a person, not a number