Personalized medicine is no longer the medicine of tomorrow, but rather an innovation in health care that is becoming increasingly popular. The concept has received the most attention in oncology, where trial and error with medications is less forgiving than in other therapeutic settings. In the field of mental health, although drug side effects are generally less serious than in oncology, trial and error is common and often a source of frustration and discouragement. The impact of an ineffective or poorly tolerated treatment may be more difficult to calculate, but it can nevertheless be costly to productivity, quality of life and academic success for patients with attention deficit disorder with or without hyperactivity (ADHD).
ADHD: 30% failure rate for psychostimulants
Although most patients treated for ADHD respond well to first-line medications (psychostimulants based on methylphenidate or amphetamine), 30% are refractory to initial treatments and require several trials to find a suitable one. 1 Designed to provide the doctor with a tool to reduce trial and error, the ADHD Pharma profile identifies medications that are potentially incompatible or may require specific dose adjustments.
Results of retrospective study
Recently, a retrospective study conducted by BiogeniQ demonstrated a relationship between the clinical experience of participants and pharmacogenetic testing. To measure this correlation, each participant provided their prescription history, which was then compared to their pharmacogenetic test result (ADHD Pharma profile). Patients reported the medications they had taken, which drugs were discontinued, and any dose adjustments that were made. Every time a patient’s pharmacogenetic report indicated a risk of incompatibility for a particular medication used, the drug had either been discontinued, been used in combination with a second drug, received a dose adjustment, or been reported as inappropriate due to its lack of effectiveness or the presence of side effects.
The relationship found in the study between an individual’s prescription history and his or her pharmacogenetic test result demonstrates that the ADHD Pharma profile can identify which medications to avoid, which will require dose adjustments and which should be used in combination with other drugs. In a clinical setting where a doctor has no tools to guide his or her choice of treatment, the ADHD Pharma profile can prove helpful, especially for patients being treated through trial and error. Not only can the result provide valuable information on the reason for the treatment failure, but it can also guide the choice of treatment. By making a more informed decision, the doctor can use this pharmacogenetic test to reduce the period of trial and error.
When medications cause side effects or are ineffective, it is not only a waste of time but can also cost a child with learning difficulties the entire school year. This new study supports the use of pharmacogenetics for the treatment of ADHD, particularly for patients whose initial treatments do not work.
1. Budur et al. (2005) Non-Stimulant Treatment for Attention Deficit Hyperactivity Disorder. Psychiatry 2(7): 4-48.