The Science
What is Second Generation Pharmacogenetics?
It is the integration of the information obtained from pharmacokinetic and pharmacodynamic genetic testing into algorithms to assess the complex dynamics between these processes and how they affect the effect of drugs and the response to medication.
The Three Pillars of Second-Generation Testing
1. Metabolism
Drugs must be metabolized appropriately for success. Antidepressants are absorbed through the intestines into the bloodstream, then metabolized to their active form before liver clearance.
- Two primary liver enzymes handle metabolization: CYP2C19 and CYP2D6
- 11% of the population have a malfunctioning genetic variant of one of these enzymes, while 5% of the population have both
- Standard pharmacogenetic tests work well for these enzyme variations, but success here doesn't guarantee overall treatment success
2. Brain Receptors
Drugs must be compatible with their target receptors in the brain. Antidepressants must cross the blood-brain barrier to reach target receptors, with the ABCB1 gene playing a key role.
- We are the only service that tests for the ABCB1 gene
- We test for brain receptors that directly or indirectly impact antidepressant response
- This goes beyond standard pharmacogenetic testing
3. Pathway Algorithms
Pathway algorithms provide a summation of the tested genes. Multiple gene compatibility must be evaluated simultaneously: one gene might be compatible with a drug while another isn't.
- We are the only company that deploys proprietary pathway algorithms for each drug
- This results in a definite recommendation by our pharmacists
- Our approach considers the complex interplay between all relevant genes
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