Pharmacogenetic Testing

Mental health treatment often involves a process of trial and error—trying one medication, waiting weeks to assess the effect, then switching if results aren’t satisfactory. This process can be frustrating and emotionally draining for patients and families. 

Pharmacogenetic testing offers a way to reduce that trial-and-error approach. With a simple cheek swab, we can analyze specific genes that influence how your body metabolizes psychiatric medications. This allows us to identify:

• Which antidepressants may be more effective for you
• Which antipsychotic or mood stabilizing medications you are likely to tolerate
• What dosages are optimal based on your metabolism
• Which medications may carry a higher risk of side effects

While genetic testing does not replace clinical expertise, it provides an additional layer of guidance—helping your psychiatrist make data-informed treatment decisions from the start.

Pharmacogenetic testing can be particularly helpful for individuals who:

• Have struggled with treatment-resistant depression
• Have experienced multiple failed medication trials
• Are highly sensitive to medication side effects
• Have a family history of poor medication response
• Are considering complex medication regimens (e.g., multiple psychiatric medications)

Patients with depression, anxiety disorders, bipolar disorder, ADHD, PTSD, and other psychiatric conditions may all benefit from this approach.

Pharmacogenetic testing is a powerful tool, but it’s important to understand its role.

What it can tell you:

• Whether your body metabolizes certain medications too quickly or too slowly
• Whether certain medications may be less effective for you
• Which medications may carry higher risk of side effects for you
• Guidance on which drug classes may be better suited for your unique biology

What it cannot tell you:

• It does not predict whether a medication will definitely work
• It cannot diagnose mental health conditions
• It does not replace the need for professional psychiatric evaluation

At Cohen Psychiatric, we emphasize that genetic testing is one piece of the puzzle. It is combined with expert clinical judgment, careful monitoring, and a holistic view of your mental health needs.

The field of pharmacogenomics looks at how variations in genes influence drug response. For psychiatry, the most relevant genes are those that affect cytochrome P450 enzymes—proteins in the liver that metabolize many antidepressants, antipsychotics, and mood stabilizers. For example:

• A person with a genetic variant making them a slow metabolizer of a certain SSRI may experience stronger side effects at standard doses.
• A rapid metabolizer may process the medication too quickly, meaning it never reaches an effective level in their system.

By knowing this in advance, we can adjust medication choice and dosing more accurately—potentially reducing months of trial and error.

Patients who undergo genetic testing for psychiatric medications often report:

• Faster relief from symptoms – Avoiding ineffective medications means getting to the right treatment sooner.
• Fewer side effects – Medications are chosen and dosed with your unique metabolism in mind.
• Greater confidence in treatment – You and your psychiatrist are working with more data, not just trial and error.
• A sense of empowerment – Understanding your own genetic profile helps you feel more engaged in your care.

Pharmacogenetic testing is not required for all patients, but it can be especially valuable if you:

• have not responded well to previous medications
• have had intolerable side effects with multiple drugs
• are beginning psychiatric treatment and want to optimize from the start
• have a complex medical history or are on multiple medications

During your initial consultation, your psychiatrist will help you decide whether pharmacogenetic testing could enhance your care.