Does Pillcheck test pharmacodynamic genes?

Modified on Tue, 9 Sep at 10:38 AM

The goal of the Pillcheck service is to provide clinically relevant information for prescribers and patients to optimize therapy for each individual. Pillcheck does not currently report on pharmacodynamic genes because regulatory agencies have not yet supported this practice.

The Pillcheck test analyzes only the genes recommended by the internationally recognized CPIC guideline for antidepressants. Since this guideline explicitly advises using information on genes that directly affect drug concentration in the blood (pharmacokinetic genes), the Pillcheck Report references genes pertinent to selecting antidepressants (SSRIs, SNRIs) and antipsychotic medications. The CPIC guideline also states that the level of evidence for other pharmacodynamic genes associated with drug response is not yet actionable. FDA and Health Canada drug labels include only pharmacokinetic genes related to drug metabolism.

Other proprietary psychiatric tests may assess different combinations of pharmacodynamic markers (SLC6A4, COMT, MTHFR, HTR2A) and some drug transporter genes. However, this may lead to inconsistent recommendations across tests and specific patient groups. These inconsistencies are particularly confusing for clinicians because it is unclear whether prescription changes are warranted.

To address these difficulties, the Pillcheck service includes a review of your medications by an expert pharmacist trained in pharmacogenetics. The pharmacist examines your genetic test results in the context of your current and past medication experiences, health conditions, vitamins, and supplements. In particular, they note relevant drug interactions that may “override” specific genetics-based recommendations. Without these considerations, DNA test results, when taken out of the context of a person's drug experience, can be inadequate and potentially misleading. The pharmacist's review letter addresses relevant drug-drug interactions, providing actionable suggestions for therapy adjustments.