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The Pharmacogenomics Clinic at NorthShore’s Mark R. Neaman Center for Personalized Medicine offers genetic testing and interpretation to help deliver the right drug at the right dose the first time. Clinic Director Mark Dunnenberger, PharmD, BCPS, and Psychiatrist Laura Parise, MD, team up to answer key questions about pharmacogenomics and how it helps deliver better outcomes for patients.
Q: What is pharmacogenomics, exactly? A (Dr. Dunnenberger): Pharmacogenomics relies on genetic testing to study genes specifically involved in metabolizing and transporting drugs throughout the body. Our clinic is the first-of-its-kind in the country focused on how an individual’s DNA influences their response to medications. If we find something different than what’s most commonly seen in the majority of the patient population, then we need to think differently about certain medications.
Q: It sounds like this information is helpful to physicians as much as the patient?A (Dr. Dunnenberger): Absolutely. Our physicians now have a powerful clinical decision-making tool within NorthShore’s secure Electronic Medical Record (EMR) system with built-in alerts and practical applications to help them deliver individually tailored drug therapy to their patients. Traditionally, physicians used evidence-based information on which medication is most likely to work and prescribe it on a trial-and-error basis. With pharmacogenomics, they now have more personalized data to better choose the best drug therapy the first time for a patient with a particular condition.
Q: As a psychiatrist, how do you use pharmacogenomics to treat depression and mental health issues?A (Dr. Parise): Using DNA as a tool to choose medication helps reduce side effects, as we’re able to determine if someone is highly sensitive to a specific medication—especially if they’re new to treatment. We also can better treat patients with mood and anxiety disorders, depression and addiction by using their pharmacogenomics profile to identify medications that are more suitable for their needs based on how their body uniquely responds to the drug.
Q: Do patients benefit more quickly through pharmacogenomic-based prescribing?A (Dr. Parise): In many cases, yes, since we can target treatments more efficiently and effectively. The more tools we have, the more forward-thinking we can be in terms of faster and better treatments. By focusing earlier on beneficial medications, we have the potential to diminish the effect that mental health and other illnesses have on patients and their families.
Q: Can you give an example of how pharmacogenomics helped a patient?A (Dr. Parise): I treated a patient who had been taking a certain medication for years and whose depression was in partial remission. But because they weren’t feeling 100%, they began drinking alcohol excessively and this went on for years. When the patient entered our program, we discovered that their body didn’t tolerate a certain class of antidepressants. Based on pharmacogenomics, we switched to another drug and subsequently both their depression and substance use disorder achieved remission.(Dr. Dunnenberger): I’d like to add that surveys of our patients with a pharmacogenomic screening show they’re more likely to take their prescribed medication. So, if we can help increase their adherence, the more likely we’re able to improve their health.