Genetic Testing & Its Role in Treatment

Genetic Testing

Episode Description

Medication can affect people in many different ways. In this episode of Mind Your Mind, host Tim Unsinn and psychiatric nurse practitioner Amanda Daggett talk about genetic testing and its use in discerning how different individuals might react to various medications. Tim and Amanda also touch on some of the facts and myths surrounding genetic testing, including what testing can and can’t indicate and where the science is currently at.

What to Expect

  • Pharmacokinetics versus pharmacodynamics
  • How genetic testing aids mental health treatment
  • When to seek genetic testing


Resources: Learn More

Things to Think About

  • Genetic testing is a tool, but not an end-all be-all.
  • Could genetic testing help you determine the effectiveness of your medicine?

About the Hosts

Amanda

Amanda Daggett is a board-certified Mental Health Nurse Practitioner. She diagnoses and treats mental health disorders in children, adolescents, and adults. She strives to provide competent, high-quality, patient-centered, holistic care—which includes therapy and medication management—and work with a team of professionals to help patients achieve optimal wellness.

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Transcript
Genetic Testing & Its Role in Treatment

Featuring Amanda Daggett, APRN, PMHNP-BC, Dakota Family Services

 

Host Tim Unsinn:

Welcome to Mind Your Mind, a podcast presented by Dakota Family Services, an outpatient behavioral health clinic, located in Minot, Bismarck, and Fargo, North Dakota. In this podcast, I will talk with our experts about understanding and nurturing our mental health and wellness. I'm your host, Tim Unsinn. Join me each episode as we explore the intricacies of our minds, decrease the stigma of mental illness, learn practical tips for managing our mental health and wellbeing, and recognize when it's time to ask for help. Join me now to Mind Your Mind.

Host Tim Unsinn:

Welcome to this episode of Mind Your Mind. Our guest is Amanda Daggett. Amanda is a psychiatric mental health nurse practitioner. Amanda, great to have you on Mind Your Mind. Our topic is genetic testing. However, before we get to the topic, there's a question I ask all of our guests on Mind Your Mind, and that is why do you do what you do?

Amanda Daggett:

That is a very good question and one I had to think about a little bit. Why I do what I do is I'm really driven to help people and to make a difference in people's lives. Whether that's my patients or my coworkers or my family, I like to help, which a lot of nurses do. We're helpers.

Host Tim Unsinn:

Absolutely. Great answer. So our topic is genetic testing and when I first saw the topic, I'm like, oh, interesting. So what genetic testing is available in psychiatry?

Amanda Daggett:

So we don't have genetic testing to say like, am I at risk for depression or schizophrenia? We don't have a specific genetic marker, like one specific genetic marker that we can identify and test for. What we do have genetic testing for is to see kind of how the body, what it does to medications, and what medications do to the body. So that's pharmacokinetics and pharmacodynamics. So there's certain genes that we've identified that there might be a gene-drug interaction. So we have certain companies that we can test through like GeneSight and Genomind. And what they can tell us is, you know, some people are fast metabolizers or some people are slow metabolizers, so maybe your body is getting rid of that medication really fast and we might need a little bit of a higher dose for it to work. Or your body's getting rid of it really slow, so maybe we need to dose it a little low or we could worry about toxicity or the increased potential for side effects. So that's the pharmacokinetics part. The pharmacodynamics part is what is that drug doing to your body? So there are certain genes that we have identified that, you know, maybe put you at an increased risk for dangerous side effects like Steven Johnson Syndrome and so then we could say, you know what, this medication we should probably avoid because it could be a little more dangerous for you.

Host Tim Unsinn:

Well I can see then how genetic testing aids in treatment of mental illness, right?

Amanda Daggett:

Yes, it definitely does. It's one tool that we can use, so it's not gonna be an end all be all. Like it's not gonna tell us like, yes, this medication is definitely gonna work for you, but it's a tool that we can use where we can say, Hey, maybe we need a little bit higher dose for this to work for you. Or this isn't gonna be the right medication for you because it could be more dangerous for you.

Host Tim Unsinn:

Well, it seems like it's just another tool in the toolbox to help us be better.

Amanda Daggett:

Definitely.

Host Tim Unsinn:

Alright, now as far as the genetic testing, when, when should I get that genetic testing for myself or my child?

Amanda Daggett:

So when I recommend genetic testing is when we have tried several medications and we're just not getting the response that we wanna see. Or you're having side effects from medications. So that's when we could look at that and say, maybe this can help us find the right medication for you.

Host Tim Unsinn:

It seems like genetic testing, it's, you know, it's not something that's commonly heard. Do you, do you get a lot of questions from patients when you start talking about genetic testing?

Amanda Daggett:

Actually I have a lot of patients that ask about it. So I think this is something, I don't know if it's advertised well online or if this is something that's being spread by word of mouth, like other people saying, "Hey, I did this and it really helped me find the right medication." So I actually have a lot of patients coming in asking me about it.

Host Tim Unsinn:

Well that is great to know. So as we think about genetic testing, any other thoughts that you have on it as far as things that maybe, because you mentioned it's, it's not an and all be all.

Amanda Daggett:

Yeah.

Host Tim Unsinn:

So what are some of the, the fallacies about it? Some of the myths and truths.

Amanda Daggett:

Okay. So a lot of people come in with the perception that it is an end all be all. Like it's gonna say, oh, this tells me which medication is gonna work. So that's just a little bit of explaining it better. The other thing is, the science just isn't there yet. Like while we've identified some genes that have, you know, that influence the way the drugs work in our body or what we do to the drug, we haven't identified a lot of them. And I'm sure there's so many more that eventually we will identify. So there's gonna be changes and advances in it. The science just isn't where we would like it to be.

Host Tim Unsinn:

Alright, well it's a good topic. Great topic, interesting topic if you will. As people learn more and more about it, ask more and more questions, I'm sure we'll revisit this topic down the road. As we wrap up our topic being genetic testing, knowing about that. Before we wrap up though, I always have that question I ask our guests before we do, and that is what do you do personally to mind your mind?

Amanda Daggett:

I like to take time at the end of the day to be by myself and unwind. I like to be alone in my room with like just a lamp on, you know, just really quiet and just sit by myself a little bit and allow my body and my mind to calm down.

Host Tim Unsinn:

Great. Great answer. Not a wrong answer. Always a good answer.

Amanda Daggett:

Well, thank you.

Host Tim Unsinn:

Appreciate that. Thank you. So it's always interesting to see how we all take care of our minds, but it's important that we do. Thank you so much for being on Mind Your Mind, Amanda.

Host Tim Unsinn:

Thank you for joining us for Mind Your Mind, a podcast presented by Dakota Family Services. For more information, links to additional resources, contact information, and much more, go to dakotafamilyservices.org.

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