For people who are tired of guessing
Some patients come to our Blake Street office with a long list of past medicines: three antidepressants that did nothing, one that caused severe nausea, another that helped for a month and then faded. GeneSight, a pharmacogenomic test from Myriad Genetics, looks at how your genes may affect the way your body processes and responds to many psychiatric medicines.
The science in plain English
Your liver uses enzymes to break down most medicines. Genes such as CYP2D6, CYP2C19, CYP3A4, and CYP1A2 determine how active those enzymes are. A poor metabolizer clears certain medicines slowly, so levels can build up and cause side effects. An ultrarapid metabolizer clears them so fast they may never work. The test also includes genes related to how some medicines act in the brain.
What the report shows
Medicines are grouped into categories: use as directed, moderate gene-drug interaction, and significant gene-drug interaction. A medicine in the significant group is not forbidden, but your provider may choose differently, start lower, or monitor more closely.
Who should consider it
Testing tends to help most when:
- Two or more medicines for depression or anxiety have not worked
- You had strong side effects at ordinary doses
- You take several medicines and interactions are a concern
- A family member had an unusual reaction to a psychiatric medicine
For someone trying a first medicine, standard choices usually work well without testing.
The evidence
The GUIDED trial found that patients whose care was guided by GeneSight had higher response and remission rates, though it did not hit its primary measure of overall symptom improvement. The Clinical Pharmacogenetics Implementation Consortium publishes dosing guidance for several SSRIs and tricyclics based on CYP2D6 and CYP2C19 results. Testing improves the odds; it does not guarantee results.
What the test cannot do
GeneSight does not diagnose depression, anxiety, or ADHD, and it is not a list of which medicine will definitely work. Your history, symptoms, preferences, and other health conditions still drive decisions. Results are used alongside your psychiatric evaluation.
Cannabis and other substances
Cannabis, nicotine, and some supplements can also change enzyme activity. Smoking, for example, speeds up CYP1A2. Your provider considers these alongside your genetic results, because genes are only part of the picture.
What a result can look like
Imagine someone who felt sick and jittery on two antidepressants at low doses. Their report might show they are a poor CYP2D6 metabolizer, meaning those medicines built up higher than expected. Their provider could choose a medicine cleared by a different pathway, or start at a lower dose. The test did not pick the medicine, but it explained the past and shaped the next step.
Privacy of genetic results
Results become part of your medical record and are protected like other health information. A 2008 federal law, the Genetic Information Nondiscrimination Act, bars most employers from using genetic information in hiring, firing, or promotion decisions.
Questions to bring
Ask which medicines are being considered next, how the results could change that choice, and whether your family history suggests genetics may play a role.
When to hold off
If you have tried only one medicine, and only briefly, a full trial at a proper dose usually comes first. Your provider will be candid about whether testing is likely to change your plan right now.
The steps
You and your provider decide together whether testing could change your plan. A quick cheek swab is taken and sent to the lab. When results arrive, your provider explains them and how they shape your next medicine choice.
A lifetime of use
Your genes do not change, so the report remains useful years from now. With your permission, it can be shared with other prescribers, which can help when other doctors choose medicines for pain, heart conditions, or stomach problems.
Getting started
Testing is ordered through your care with us and paired with medication management. Visit 2301 Blake St in Denver, and become a patient to ask whether it makes sense for you.
Why Choose Elevate Denver Mental Health?
- Now accepting new patients across the Denver metro and all of Colorado - no 3-month waitlists
- Board-certified psychiatric providers, not just therapists
- We take most major insurance, plus Medicare — and keep costs transparent
- Real evaluations, not 10-minute med checks