One in 10 Canadians will expression major depression at some point in their lives, yet finding and accessing effective treatment options remains difficult. While part of this issue lies in the lack of accessible mental health care throughout Canada, even those undergoing treatment often struggle to find medication options that are able to reduce their symptoms.
Thanks to a special kind of genetic testing, however, Canadians dealing with major depression may soon have access to a faster, easier method of finding medications that work. According to new research from the University of British Columbia, this special genetic testing could lead to 37% fewer patients experiencing treatment-resistant depression.
The study, which also included contributions from Simon Fraser University, was published in the Canadian Medical Association Journal.
Patients struggle to find the right medications
More than 35 different antidepressant medications are available in Canada, yet finding the right medication for a particular patient can be tricky. Over half of all patients prescribed antidepressants do not find any improvement with the first medication they’re prescribed, while roughly 27% report negative effects from their first prescribed antidepressant. This is not only discouraging for patients, who often struggle to even access care in the first place, but also places a large burden on the healthcare system.
Previous research has indicated that genetic factors may play a role in why certain medications do or don’t work for different patients. The goal of the present study was to determine whether genetic testing could offer patients a more streamlined process for finding medication options that work for them.
“Genes play an important role in how our bodies metabolize different antidepressants, which ultimately influences their efficacy,” explained Jehannine Austin, co-senior author of the study and Professor of Medical Genetics and Psychiatry at UBC, in a press release.
“[G]enetic insights […] can help physicians make more informed treatment decisions and reduce the lengthy trial-and-error process that many patients experience in finding an effective medication.”
The study specifically looked into pharmacogenomic testing, which is a type of genetic testing used to help doctors prescribe medications and choose the right dosing. Genetic information for these tests is typically obtained using samples from the patient’s saliva, blood, or cells swabbed from their cheek.
The researchers simulated how implementing pharmacogenomic testing in mental health care would impact adults dealing with depression. Their simulation used insights from BC health administrative data, clinical trial data, and defined treatment strategies, and was undertaken in partnership with patients, clinicians, healthcare systems, and governmental organizations.
Genetic testing can offer valuable insights
They found that pharmacogenomic testing could result in 37% fewer patients experiencing treatment-resistant depression: that is, depression which does not improve with two or more different antidepressants. The model also predicted that pharmacogenomic testing could result in nearly 2,000 fewer deaths and 21,000 fewer hospital admissions over a 20-year period. In turn, this could translate to $950 million in savings for the provincial healthcare system.
While pharmacogenomic testing is currently only available through private companies in Canada (and is therefore not covered by provincial healthcare), these results highlight the enormous benefits that could come from implementing genetic testing early on in mental health treatment plans. According to the authors, the next step will be to investigate the best way to incorporate pharmacogenomic testing in our public healthcare systems.
Meanwhile, these results can offer hope to patients who have struggled to treat their depressive symptoms.
“All people with major depression deserve to feel hopeful about their life,” said Linda Riches, a patient partner who helped undertake the study and who has been living with major depression for more than 30 years.
“Genetic testing may give them the opportunity to know what treatment they need, not the 10 they didn’t need.”
