Psych meds and mutant genes

A little while back, I mentioned that I was having a pharmacogenomic test done, i.e., a genetic test to suss out how my body might respond to different medications.  In my case, the test was looking at antidepressants and other psych meds.  The results are in; they’re nothing dramatic, but they’ve validated my experiences with certain medications.

For example, I had been taking aripiprazole (Abilify) as a sort of helper drug to complement my primary antidepressant.  I started out taking the very lowest available dose, and when that seemed to be going well, my psychiatrist recommended increasing it.  I tried that for three weeks, went “NOPE, not OK,” and dropped back to the lower dose.  Even though my psychiatrist had given me permission to do this, she seemed disappointed and continued suggesting the higher dose.

Well, guess what?  It turns out that I have genetic markers for processing aripiprazole very efficiently; the test results note that I should “use with caution” and “lower doses may be required.”

I was right.  I was right that the higher dose was wrong for my body, even though it’s a “normal” dose for other people.

The test also looked at a gene called MTHFR, which produces the gloriously long-named enzyme methylenetetrahydrofolate reductase.  It converts folic acid to a form called L-methylfolate, which is the form used by the body and brain.  (Moms, remember how important it was to take folic acid while you were pregnant?  It’s because L-methylfolate is super important for brain and nervous system development.)

Long story short, it turns out one of my MTHFR genes is a mutant version, meaning my body might not be processing folic acid as well as it ought.  There’s some preliminary research that this is associated with depression and maybe with low energy levels.  [Cautionary note: If you’re curious about this for yourself and decide to start Googling about MTHFR, put your critical thinking hat on tight.  Those search results are going to pull up a lot of BS.  Real medical research about MTHFR seems to be fairly scarce.]

In an odd sort of way, it’s exciting to finally have a test actually find something wrong with me.  I’m depressed and I’m anxious and I’m tired, and yet all the normal tests (iron levels, thyroid hormones, etc.) are always, well, normal.  I now have a new and different thing to try: taking L-methylfolate supplements.  I’m not incredibly optimistic that they’ll make much of a difference, but one can dream.

2 thoughts on “Psych meds and mutant genes

  1. I have (well, had, because I unfriended her on facebook and that was our only means of communication that she would actually use, which is a bummer, because we used to be really close) a friend who has two mutated MTHFR genes. Agreed that actual research is scarce, as I tried to pubmed the crap out of it to try and help her. She would continually post weird stuff from websites trying to sell her stuff and then tell me that’s the real truth and that scientists were biased but not this weird guy selling stuff.

    It’s fascinatingly weird and really makes me think we all need to do gene tests to understand our own bodies and medicine better. Also makes me wonder if having a doctor might become a very different thing as we understand different genes better. Will we be able to actually do personalized medicine? How will we train doctors to be prepared for this? How much do gene variants truly matter?

    Also, what company did you use? I’d be interested in trying that at some point. I also really want to do that genetic thing where you and family members send in DNA to see what haplotypes you match with from which regions.

    Oooh, science.

    Liked by 1 person

    • Good questions! My vision of future medicine comes from Star Trek, where they just scan you with a little thingy and know everything that’s wrong and how to fix it. I suspect the interaction between genes and drugs and illness isn’t quite that deterministic, but I think it’s really cool that we can do as much as we can do now.

      GeneSight is the company that does these. I think you have to go through a doctor—I don’t think they do direct-to-consumer tests. It ran about $300 since my insurance wouldn’t cover it.


Comments are closed.