A question worth asking
After the third or fourth medicine that did not work, most people start to wonder whether something about their body is different. Sometimes the answer is the diagnosis, the dose, or the timing. Sometimes part of it is genetic. One place to look is a lab test called GeneSight, from Myriad Genetics, which reads genes tied to how your body breaks down and reacts to dozens of psychiatric medicines.
How the test works
Your provider collects a quick cheek swab. The lab examines genes such as CYP2D6 and CYP2C19, which make liver enzymes that clear many antidepressants. People with slow versions can end up with high medicine levels and side effects at normal doses; people with very fast versions can clear a medicine before it has a chance to work.
What you get
A report that groups common medicines by predicted gene-drug interaction: use as directed, moderate, or significant. A medicine in the significant group is still an option, but your provider may pick another, start lower, or watch more closely.
When it makes sense
- Two or more medicines for depression or anxiety have failed
- Ordinary doses caused unusual side effects
- You take several prescriptions and interactions are a worry
For a first psychiatric medicine, testing usually is not needed.
Evidence, plainly
The GUIDED trial found more patients responded and reached remission when their providers used GeneSight results, though it missed its main target for average symptom change. Independent expert panels also publish dosing advice for several antidepressants tied to CYP2D6 and CYP2C19 status, and your provider follows it. It helps the odds without guaranteeing anything.
What it does not do
It does not diagnose any condition, and the FDA has not approved it for picking antidepressants. Your provider uses it together with a full psychiatric evaluation and your own goals.
A Greensboro example
Imagine a Guilford County teacher who felt nauseated and jittery on two antidepressants at the lowest doses. Her report might show that her CYP2D6 enzyme barely works, so even tiny doses climbed high in her blood. With that in hand, her provider could reach for a medicine her liver handles by a different route, or begin at a fraction of the usual dose and step up slowly.
Pain and heart medicines
Many of the same enzymes process pain, heart, and stomach medicines. With your consent, results can be shared with your other doctors at Cone Health, Novant, or Atrium Health Wake Forest Baptist.
Who sees it
The report is filed with the rest of your protected medical record. Congress passed the Genetic Information Nondiscrimination Act in 2008, which bars most employers, from the furniture showrooms to the FedEx hub, from using genetic results to decide who gets hired, fired, or promoted.
LabCorp and lab-savvy patients
Burlington is home to LabCorp, and many patients there understand lab testing well. Your provider is glad to go into as much technical detail about the panel and its limits as you want.
Older adults
Many retirees in Greensboro, Winston-Salem, and High Point take medicines for blood pressure, reflux, and pain alongside an antidepressant, and several of those compete for the same liver enzymes. Pairing the report with a careful review of every bottle helps your provider avoid combinations that quietly pile up.
Family clues
Did a sister do great on sertraline while your dad could not tolerate it? Bring up stories like that. Your own swab is what counts, but relatives' experiences help your provider read the results in context.
Family clues
If a parent or sibling had an unusual reaction to a psychiatric medicine, mention it. Each person needs their own test, but family history can point in a useful direction.
Questions to bring
Which medicines are next on the list? How could results reorder it? What would we do if every column came back clear?
When to wait
Three weeks on one medicine is not really a fair test. If that is your whole history, your provider will usually suggest a full trial at a proper dose before any lab work, and will say plainly if a report would not change the next move.
Getting started
Ask about testing at any visit; it becomes one more tool in your medication management. A staff member can collect the swab at whichever office is closest: 447 Arlington St in Greensboro, 102 W 3rd St in Winston-Salem, 1831 Eastchester Dr in High Point, 500 S Main St in Burlington, and 135 MacArthur Street in Asheboro. Become a patient to see whether it fits your history.
Why Choose Triad Mental Health Partners?
- Providers across Greensboro, Winston-Salem, and the Piedmont Triad 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