Treatment resource index and toolbox

Treatment Resources Index

Peter Forster About GPS, GPS Update Leave a Comment

This weekend we have done some hard work behind the scenes creating a better treatment resources index to allow clinicians and patients to quickly access information about the array of services, online applications, clinical tests, pharmacogenetics tests, online courses and online CBT therapies that are provided at Gateway Psychiatric. There are so many tools in our toolbox that it can …

Genetic Tests for Antidepressants – CNS Dose

Peter Forster Best Practices, GPS Update, Major Depression, Testing, Treatments of Depression Leave a Comment

About a year ago we reviewed the data on the use of genetic tests for antidepressants as well as other medications and identified three pharmacogenetic panels that seem to have research support: Genecept by Genomind, Genesight, and CNS Dose. Of these three we have been using Genecept and Genesight with some success but now we are happy to add to …

Antidepressant Response Linked to Norepinephrine Transporter Genotype

Peter Forster Best Practices, Major Depression, Testing, Treatments of Depression

A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …

Genesight – Genetic Testing to Predict Medication Response

Peter Forster GPS Update, Psychobiology, Testing

We have been using the Genecept Assay from Genomind for several years to help guide treatment selection in patients with either unusually high rates of side effects from medications or those who have failed multiple trials of medications. Although the test can be expensive, costing anywhere from a couple of hundred dollars to five hundred dollars or more, it is our experience …

Genetic Tests for Depression Reviewed

Peter Forster Best Practices, Major Depression, Psychobiology, Testing

Are genetic tests for depression treatment worthwhile? Or is this an expensive technology that is not ready for routine use? Peter Roy-Byrne, writing in NEJM Journal Watch seems to say no. Although some clinicians may argue that such testing “can’t hurt and might help,” current psychopharmacological practice is complex, usually including combinations of multiple medications, and patients can have multiple …

Genetics of bipolar disorder – update

Peter Forster Psychobiology

Unraveling the genetics of bipolar disorder has been a much more complicated task than anyone thought. Although the best estimates suggest that genetic factors account for the very high percentage of the risk of developing bipolar, with an estimated an estimated 0.7 to 0.8 heritability (Sullivan), it has been remarkably difficult to find genes with significant individual effects that are replicated …

Lithium and Genes

Peter Forster Bipolar Treatment, Psychobiology, Testing

Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …

SAMe – S-adenosyl-methionine

Peter Forster Major Depression, Treatments of Depression

S-adenosylmethionine, or SAM-e for short, is one of the few nutritional supplements that has good clinical research to support its safety and effectiveness. Although SAM-e is used for many purposes, we are particularly interested in it as a compound that may have antidepressant properties. S-adenosylmethionine (SAMe) is involved in many reactions that involve methylating chemicals (transferring a methyl group to the …

ABCB1 Gene Predicts Antidepressant Response

Peter Forster Basic Science, Major Depression, Psychobiology, Testing, Treatments of Depression

An article that will soon appear in the American Journal of Psychiatry suggests that it may be possible to predict who will respond to different antidepressants using a genetic test. The study looked at whether by testing for specific genetic variants of a protein involved in transporting drugs and other potentially toxic substances into and out of cells and across the blood …

Genetic Testing for Depression Drugs

Peter Forster Costs of Treatment, Major Depression, Testing, Treatments of Depression

Genetic testing for depression drugs is a new approach to selecting medications that may have value, especially in patients with treatment resistant depression. We have been using the Genecept Assay for patients with treatment resistant depression and have found that the results improve our ability to choose effective treatments. Patients who have failed multiple adequate trials of medications are much less likely to …