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A Patient's Perspective on Pre-Emptive PGx
My name is Simon Dean, and I wanted to share with you the results of my pharmacogenomics test from the perspective of a patient.
What Is Pharmacogenomic Testing?
Pharmacogenomic testing is becoming increasingly important, particularly in the UK where interest in personalised medicine is growing. But what exactly is it? A pharmacogenomic test is a type of genetic testing for psychiatric medications and other treatments. It's a DNA test that shows how your body responds to different medications.
The comprehensive report I received covers 115 different medications and might be recommended if you have adverse drug reactions, bad side effects, or if certain medications simply aren't working for you. Alternatively, you might be considering pharmacogenetic testing UK-wide if you want to get it right the first time, removing the trial-and-error approach to prescribing.
Why a Doctor Might Recommend a Pharmacogenomics Test
This is really why a doctor might recommend one of these tests. It helps ensure you can either start on the best drug the first time around or optimise the dosage to suit your unique metabolism. Pharmacogenetic testing can be especially useful when choosing between similar medications, for example, if you're deciding between citalopram or sertraline.
How Pharmacogenomic Reports Are Structured
I like to think of the report as having two main types of insight: high-level insight and a medical deep dive.
High-Level Insights
In the high-level insight, you can see all 115 medications broken down into different categories such as:
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Analgesia
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Autoimmune
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Cancer
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Cardiovascular
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Endocrinology
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Gastroenterology
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Infection
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Mental health
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Neurology
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Respiratory
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Rheumatology
Within each section, medications are tagged as a 1, 2, or 3:
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Mild or no known drug-gene interactions
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Moderate interaction
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Serious drug-gene interaction (steer clear)
Moderate Interactions (2-Tagged Drugs)
Going deeper, the twos are expanded with advice:
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Consider alternative medications
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Increase or reduce the dose
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Be aware of possible reduced efficacy
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Increased risk of adverse drug events
It's vital information for your doctor to have when prescribing.
Deeper Dive: Medication-Specific Insights
Where doctors really get excited is when we go deeper into the report, looking at specific medications and how your body is predicted to metabolise them.
Citalopram vs. Sertraline
For instance, looking at a well-known antidepressant like citalopram, often recommended for depression or anxiety, my report shows I'm a rapid metaboliser because of my CYP2C19 pathway. This means I process citalopram more quickly than average, and it may not reach effective levels in my body. In this case, being a rapid metaboliser is undesirable because the drug is cleared from my system too quickly to be effective.
This insight answers a common question: what's the difference between sertraline and citalopram for someone like me? While both are antidepressants, the test showed that sertraline is a better option for me; it's in the "1" category, meaning no concerning gene-drug interactions were found.
If you've ever wondered, "are citalopram and sertraline the same?" - they aren't, especially when your genetics are considered.
Clopidogrel: An Important Genetic Insight
While discussing the "C" section of the report, another important drug is clopidogrel, a blood thinner often prescribed after a stroke. Here, I am also classified as a rapid metaboliser via the CYP2C19 pathway. Whereas with Citalopram, this is less desirable, with Clopidogrel, it’s not an issue. Clopidogrel is a "pro-drug," meaning it needs to be metabolised by the body into its active form. Rapid metabolism ensures that the drug is efficiently converted into its active, effective form, helping prevent blood clots as intended.
Clozapine: Another Drug with Popular PGx Guidance
Another drug highlighted is clozapine, used for treating schizophrenia. My report shows that I'm an intermediate metaboliser via the CYP2D6 pathway. So if I were ever to need this drug (which is unlikely for me), I would take it as prescribed.
How Pharmacogenomics Testing Works as a "Drug Passport"
Pharmacogenomic testing UK services like AttoDiagnostics offer this test as either a "drug passport" you can keep for life or a point-of-need diagnostic when a doctor is considering medication options. Your genes don't change, meaning you can take your pharmacogenomics test results to any future medical appointments to aid prescribing decisions.
Where to Get Pharmacogenomic Testing in the UK
If you want to explore the difference between citalopram and sertraline UK-specific advice or simply understand pharmacogenetic testing better, you can visit AttoPGx as a consumer or AttoDiagnostics if you're a healthcare professional looking for more detailed pharmacogenomics testing UK information.
Pharmacogenomic testing is a powerful tool, whether you're seeking clarity on medications like citalopram sertraline or simply aiming to optimise your health outcomes through genetic insights. I hope you found this information useful.