Using Pharmacogenomics (PGx) to Choose the Best Medication for ADHD

PGx for ADHD Conditions

Pharmacogenomics (PGx) offers a tailored approach to choosing ADHD medications based on a patient’s genetic profile. Choosing the best medication for ADHD (Attention- Deficit /Hyperactivity Disorder) can be a challenging task and careful evaluation of various factors such as the patient’s characteristics, side effects that could potentially arise and their response to any previous treatment is needed. PGx testing can be very valuable for choosing the best medication to use in treating ADHD patients.

What is Attention-Deficit/Hyperactivity Disorder (ADHD)?

Attention-Deficit/Hyperactivity Disorder(ADHD) is a neurological disorder characterised by an ongoing pattern of inattention and hyperactivity -impulsivity. ADHD is typically diagnosed in childhood but can persist into adolescence and adulthood. There are three types:

·        Predominantly Inattentive Presentation

·        Predominantly Hyperactive-Impulsive Presentation

·        Combined Presentation

ADHD can be treated with medication and by means of behavioural therapy.

What is Pharmacogenomic Testing (PGx)?

Pharmacogenomics is the study of how an individual’s genetic makeup affects their response to various medications. Patients metabolise and respond to medications differently as their genetic makeup is different. Certain individuals might metabolise a drug quickly – resulting in them not being effectively treated by that medication and other individuals might metabolise a drug more slowly – resulting in them having a higher plasma concentration of the drug for longer, thus worsening side effects.

 

Benefits of PGx Testing in ADHD

Optimising Treatment

In the Mental Health space, pharmacogenomics testing is highly beneficial in treating ADHD as it can optimise treatment strategies, reduce costs, reduce adverse drug reactions, and reduce the length of the trial-and-error process of getting the right treatment for a patient. PGx allows for a more personalised and optimised medication selection as it can help identify which medications are more likely to be effective based on an individual’s genetic profile. For example, the variations in genes such as CYP2D6 and CYP3A4 that are involved in metabolism can affect how well stimulant medications are processed and used by the body. 

Minimising Side Effects

 With pharmacogenetic testing, side effects are minimised as the test can predict how an individual metabolises a particular drug. This prediction will assist in reducing the side effects that occur, allowing the practitioner to prescribe medications that are less likely to give a patient problematic side effects. The patient is also more likely to adhere to the treatment as they are not experiencing unpleasant or unwanted side effects.

Improving Treatment Adherence and Reducing Costs

With the length of the trial-and-error process being reduced, the cost of treatment will be reduced. The patient will experience better outcomes because of the combination of effective medication choices, the right dosing and minimised side effects can lead to better clinical outcomes that will encourage the patient to adhere to treatment.

Common Medications for ADHD

The medications that are used to treat ADHD are divided into two categories: stimulants and non-stimulants. Stimulants are the most prescribed for ADHD and they work by increasing the levels of neurotransmitters (dopamine and norepinephrine) in the brain. 

Stimulants include methylphenidate- based medications, examples include: Ritalin, Concerta, Metadate, Daytrana, Quillivant XR (liquid form) and Amphetamine-based medications, examples include: Adderall, Vyvanse, Dexedrine, Evekeo, Mydayis. Non-stimulants are mostly prescribed when stimulants are ineffective for the patient and cause unwanted side effects. Examples of non-stimulants include Atomexetine, Guanfacine, Clonidone and Bupropion.

Because each of the medications mentioned can have different effects and side effects on each patient, pharmacogenomics testing can be beneficial to reduce the trial- and-error period for the patient, ensuring that their symptoms are relieved, ultimately improving the quality life of the patient.

For more information on our PGx testing services and how they can benefit your practice, please request a quote.