Through their participation in the IMPACT research study (Individualized Medicine: Pharmacogenetic Assessment & Clinical Treatment), practitioners in Canada are now able to offer certain patients a saliva-based genetic test to predict which psychiatric medications work best for them. The tests enable physicians to use a patient’s genetic makeup to help predict which medications are safe to prescribe, and which ones may be ineffective or cause side effects. The tests are aimed at minimizing trial-and-error prescribing/dosing and are expected to reduce associated health care costs. The pharmacogenetic tests, currently offered to Centre for Addiction and Mental Health (CAMH) clients and registered patients at the Thornhill Medical Centre, use DNA from saliva collected with Oragene for the purposes of the research. Plans are being made to incorporate several other Ontario healthcare facilities into the IMPACT study. This study is making the promise of personalized medicine a reality.

IMPACT study and saliva DNA

This initiative is part of the larger IMPACT study, headed by Dr James Kennedy at CAMH, Canada’s largest mental health and addiction teaching hospital and is funded in part by the Ontario Ministry of Research and Innovation and a private donor, Mr. Larry Tanenbaum. IMPACT researchers aim to assess the effectiveness of genetic testing over seven years in thousands of patients. They are also seeking to identify new genetic markers involved in medication response and development of adverse side effects.

Using DNA from a saliva sample collected with Oragene, variations in five genes are analyzed to predict a patient’s response to 19 common antidepressant and antipsychotic medications for the study. Medications that are compatible with an individual’s genetic makeup in terms of medication response and low risk of side effects, get a green light to prescribe as directed. A yellow light signals caution. For each medication in this category, the tests will show whether dosing levels need to be decreased or increased, or that the drug’s effects may not be optimal for this patient. Medications in the red light category should be avoided if possible, or used with caution and more frequent monitoring, due to side effects or lack of response if no alternatives are available.

Oragene is ideal for DNA sample collection for this type of research study as it offers a convenient, non-invasive and reliable sample. Patients can provide a sample at point-of-care allowing for faster implementation of optimized treatments.

It is expected that these tests will improve patient satisfaction and safety, and have a substantial impact on reducing health-care costs. According to the World Health Organization, depression will be the single biggest medical burden on health by 2020. With 1 in 5 Canadians estimated to experience mental illness at some time in their lives, the cost savings could be dramatic. The information provided in the testing will also better equip doctors to prevent complications from medications before they occur.

Oragene’s non-invasive collection method and ease of use is removing barriers to pharmacogenetic testing for psychiatric mediations for this CAMH study. Congratulations to CAMH on this great initiative.

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