JACKSON, Miss. (WJTV) – The day is coming, it seems, when your prescription medicine may fit you as comfortably as a tailor-made suit, an alternative to a less-customized treatment right off the pharmaceutical rack.
At the University of Mississippi Medical Center (UMMC), the technology in the field that makes this adaptation possible has been available for years in this field: medical genetics and precision medicine.
It has mobilized advances in patient care, helping physicians diagnose a patient early, before symptoms set in; helping them propose preventive measures for those who inherited certain gene mutations that can lead to disease; and more.
While it has been a welcome windfall in cancer therapy, now a particular feature of precision medicine is being harnessed for the practice of psychiatry: pharmacogenomics.
“It can save time; it can save resources. It can help us avoid prescribing a treatment that might have severe side effects. That’s a wonderful benefit,” said Dr. Scott Rodgers, chair of psychiatry and human behavior at UMMC.
Pharmacogenomics harmonizes a medication with a person’s genetic makeup, or genome – an individual’s complete set of DNA; it enables physicians to fashion, like a tailor with a client’s body measurements, individualized care for a patient with depression, addictions, mood disorders and more.
“In psychiatry, for many years, we have focused on the trial-and-error approach for pharmacotherapy [drug therapy],” said Rodgers. “One treatment may not work for a certain patient. It may have side effects for one patient but not for another. We don’t really know unless we do a trial, which can last months. Some patients respond right away to a medication; for other patients, you may need to try many treatments before you land on one.”
“Pharmacogenomics testing detects how your unique genes respond to a certain medication; this requires information about your genetic makeup,” said Ladner, professor of psychiatry and human behavior, director of the Division of Adult Psychiatry, and director of outpatient psychiatry.
Your genome carries an estimated 30,000 genes, each of which makes certain proteins called enzymes that metabolize (put to good use), substances, including medicine.
“But that metabolism varies from person to person,” Ladner said. That’s where testing comes in.
The immediate hope is that pharmacogenomics is leading to reduced risks for patients, including side effects. Rodgers cautions that there are limitations for the practice of psychiatry.
“We don’t want to overpromise and under-deliver according to our patients’ expectations. Precision medicine is probably strongest in the area of oncology and it’s used here routinely in the Cancer Center and Research Institute. For psychiatry, for now, its usefulness is that it tells us which side effects can occur; it lets us know how to adjust dosages. This is very important. So we want to be on the front end of this technology, and as we use it, it will improve. Our trainees and faculty will become more familiar with pharmacogenomics, and here we will be at the forefront of discovery.”