Pharmacogenetic Testing Among Patients With Mood And Anxiety Disorders Essay

General anxiety disorder (GAD) is a common condition that has both psychological and physiological components. Psychologically, the patient can feel fear, apprehension, and dread for extended periods. Physiological symptoms include the sensation of racing heart, palpitations, trembling, weakness, fatigue, dry mouth, and shortness of breath (Rosenthal & Burchum, 2019). These symptoms can be disabling and make the tasks of daily life very difficult. Fortunately, many medications can help these patients feel better and increase the quality of their daily lives. The major challenge in treating GAD is finding which medication works best for the patient. Four approved drugs increase two neurochemical transmitters in the brain, serotonin, and norepinephrine. These medications, which are first-line treatment options, inhibit the reuptake of these essential neurotransmitters, allowing their respective levels to increase in the brain. Ideally, increasing the appropriate levels will decrease the adverse symptoms. But altering these chemicals is a slow process, and it takes weeks to assess the full effects and benefits of the medications. I recently had a patient suffering from adverse effects of the anxiolytic medication that she was prescribed for GAD. Pharmacogenetic Testing Among Patients With Mood And Anxiety Disorders Essay The 57-yr-old female patient was newly diagnosed with GAD and depression after losing her longtime husband. She was prescribed Lexapro, or escitalopram, a selective serotonin reuptake inhibitor, at 20 mg daily. Her PCP increased the dose from 10 to 20 mg at her last follow-up. She came into urgent care due to agitation and insomnia, both common side effects of the medication (Brown University, 2019). She reported that she had experienced a decrease in symptoms prior to the dose increase and felt a little better. The pharmacodynamics of the increased dose had been too much for the patient. The patient was advised not to stop the medication entirely but to take the lower amount and to schedule an appointment with her PCP for further evaluation. The mechanisms of pharmacodynamics are not always clearly understood in psychological treatments. Technological advancements have brought genetic research and the importance of pharmacogenetics into question in mainstream medical therapies. One study found that although not yet a readily available option, genetic testing to direct anxiolytic and antidepression medication therapy reduced healthcare cost burdens compared to the traditional route of treatment (Perlis et al., 2018). Genetic testing has isolated specific gene sequences that have been found to code enzymes known to influence 27 medications commonly used in the psychiatric practice setting (Perlis et al., 2018). In my patient with the intolerance to the increased dose of Lexapro, pharmacogenetic guided medication therapy could be very effective in determining her best potential match for treatment. Although this may be a costly way to obtain medicine in the beginning, the benefit of the precise pharmacodynamic match would save months of trial- and-error therapies in addition to the mental anguish of worry and delayed response. As a person suffering from anxiety and depression, I completely understand the challenge and increased stress of attempting to find the best treatment and always wondering if it is the best treatment available.  Pharmacogenetic Testing Among Patients With Mood And Anxiety Disorders Essay

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The use of genetic testing for psychotherapeutic medication administration is an excellent resource for the treatment of GAD and mood disorders. Pharmacogenetic testing takes the lengthy guesswork and added stress out of the hunt for the best pharmaceutical therapy. As opposed to the traditional way of finding suitable anxiolytic treatment, genetic testing would greatly benefit this patient. Pharmacogenetic Testing Among Patients With Mood And Anxiety Disorders Essay

Brown University. (2019). Your medication information. The Brown University Psychopharmacology Update, 31(1), 9–10. https://doi.org/10.1002/pu.30527

Perlis, R. H., Mehta, R., Edwards, A. M., Tiwari, A., & Imbens, G. W. (2018). Pharmacogenetic testing among patients with mood and anxiety disorders is associated with decreased utilization and cost: A propensity-score matched study. Depression and Anxiety, 35(10), 946–952. https://doi.org/10.1002/da.22742

Rosenthal, L. D., & Burchum, J. R. (2019). Lehne’s Pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.]\
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