I have spent the last two years of my life fighting depression. It is not the first time I have battled it, but this has been the worst. The first time I was severely depressed, I took an antidepressant. It took several tries to get the right medication at the right dosage, but eventually it helped me overcome the depression. It was not without side effects, though. The most notable was insomnia. For the 10 years I was on this medication, I averaged about four hours of sleep a night.
When I felt I was in a great place emotionally, I stopped taking the antidepressant. I did really well for a few years until I had some serious disruptions happen in my life. This time, I did not want the side effects of the antidepressant, so I decided to combat it with natural remedies, including supplements, meditation, and exercise. It has taken me two years to get it under control. I am sometimes angry and frustrated because I feel like I have lost two years of my life to this condition. The antidepressants could have fixed it in a few months, but being exhausted isnít necessarily better than being depressed.
To be clear, I donít have a problem with prescription medication. Most of us survive one or more ailments because of prescription medications and since the FDA was created in 1938, by the Food, Drug, and Cosmetic Act, consumers have been reasonably secure in the fact that their prescription medications are safe and efficacious. However, we have learned that medications work better some than for others. Thus the bad side effects for some people, while others can take a drug with no problems. This often seems hit and miss.
Recently, one cause for this difference has come to light through genetic testing. It has been discovered that some drugs work by acting on variations of specific genes. Depending upon your genetic makeup, a drug might work really well for you, while another will not, or even worse cause a negative reaction. This particular branch of genetic testing is called pharmacogenomics.
It is amazing what we have discovered since the human genome was mapped. We have been slowly expanding how we use this information. It is used to solve crimes and determine paternity. We can test for certain genes or faulty copies of genes to determine risk factors for certain diseases like cancer. In a procedure called Preimplantation Genetic Screening, testing is even used in combination with In Vitro Fertilization to make sure embryos are healthy and chromosomally normal.
So, one of the next steps for genetic testing is this study of pharmacogenomics. With this knowledge, doctors can run genetics tests on their patients to discover which medications might work better for them. There are limitations. It is not a guarantee but more of an indication of whether a drug will work better for this patient than another. It will also give an indication of a good starting dosage.
Another limitation is that it is also not available for all drugs. So far they have only found a few types of drugs that are affected by genetic makeup, the most common being those for cardiology, depression/mental illness, and pain management.
Whatever its limitations, it is effective enough that Medicare will now cover the cost for genetic testing to find the best antidepressant for senior patients. It saves enough time and cost by avoiding trial and error prescribing for seniors that it has been included in the coverage.
So, now my frustration comes out about the past two years of avoiding antidepressants because of the side effects. Where would I be today if I had been able to take advantage of pharmacogenomics? Would I have saved two years of my life? What could I have accomplished in the time I spent researching supplements or just laying in bed too exhausted to get up? I will never know. I believe I have gained valuable information about myself through the process and that is a good thing. However, if I ever have to recommend a friend seek help for depression, I will be sure to mention the option of pharmacogenomics (even if I have problems pronouncing it!).