Nikolai Vassev is Founder of Mindleap a telehealth app that allows users to track their well-being & connect with mental health specialists.
Over the last two decades, an improved understanding of the role that genetics play in mental health and disease has revolutionized approaches to healthcare and precision medicine. From innovations in gene-editing technologies, such as CRISPR, to referencing large-scale genetic repositories to predict hereditary disease risk, healthcare providers are beginning to leverage detailed patient profiles and emerging technologies to optimize treatment outcomes.
Despite the potential to improve predicted prognoses, drug selection and patient outcomes, precision medicine approaches have not been fully embraced across all healthcare sectors. The vast majority of mental health diagnoses and treatment strategies are not tailored to individual needs. Instead, healthcare providers largely rely on outdated systems of tracking, classification and prediction to screen individuals for risks of adverse outcomes.
Filling The Precision Medicine Technology Gap
In recent years, genetic or DNA testing products have emerged in healthcare settings. These products help diagnose or rule out suspected genetic disorders to predict risks for specific conditions or to acquire personalized insights to customize medical treatments based on an individual’s genetic makeup.
According to the National Institutes of Health, genetic tests are available for more than 2,000 genetic conditions. It is estimated that the global genetic testing market value accounted for nearly $13 billion in 2019 and is forecasted to nearly triple by 2026, highlighting the vast consumer appeal in personalized healthcare solutions. For example, 23andME, a direct-to-consumer DNA test that includes 55-plus health reports, has raised nearly $800 million in funding and was last valued at $2.5 billion.
How Genetic Screening Technology Currently Works
Best practices for integrating genetic testing typically begin with collecting patient medical and family history through interviews or questionnaires. If a clinically significant variant for a suspected diagnosis has already been identified, then targeted testing for that variant is conducted. Although targeted testing is typically quicker and less costly, it becomes a scientific process of elimination without preidentified genetic targets.
Without available information, clinicians are compelled to offer more expensive and time-consuming methods that rarely have insurance reimbursement. In search of information, patients and their families may undergo test after test without answers, adding to the burdens experienced throughout the duration of treatment. Thus, clinicians will typically order whole-genome sequencing, an expensive and prolonged process relative to targeted testing. Several companies, including 23andMe and Ancestry, have brought upon a revolution of generalized genetic sequencing tests to consumers. Although these platforms do not represent diagnoses, clinicians largely view these additional data points as fruitful tools for designing personalized treatment protocols.
Targeted Genetic Screening Represents A New Frontier In Mental Health
Mental health sits at the nexus between genetics, environment, lifestyle and experiences. Until recently, clinicians only had access to three out of four. With technology and scientific advancements in targeted genomics and a refined understanding of genetic contributions to human health and disease, technologies continue to be developed that work to adapt and customize mental healthcare.
Unlike clinicians assessing patients with obvious physical ailments, a dearth of tools are available for mental health professionals when deciding on treatment plans. When a particular psychiatric condition is suspected, self-report surveys, lifestyle questionnaires and family history reports can be used to help guide treatment. Typically, when physicians determine medication to be an appropriate course of action, they refer to optimal use first-, second- and third-line treatment recommendations. Although rooted in research-based evidence, these recommendations are often generalized, are not symptom-specific and do not account for co-morbidities or drug interactions.
The Genetics Technologies Of The Future
In recent years, innovative commercial genetic testing platforms that probe for hereditary diseases and risk profiles for specific conditions have emerged. Over the next few years, these platforms are expected to play a pivotal role in tailoring medical management for individual patients.
In fact, several companies have already become models for the technology by manufacturing pharmacogenomic pre-screening platforms as tools to support clinical decision making. Leading genetics technology companies like Genesight and BiogeniQ have improved upon traditional whole-genome testing platforms by analyzing how a subset of a patient’s genes may affect their medication outcomes at a fraction of the cost. The results from these technologies can inform doctors about how each patient may respond to certain medications, thus avoiding unsafe and ineffective medications.
Utilizing Genetics Technology For Safe Pharmaceutical Drug Use
Although pharmaceutical drugs can play a vital role in the treatment of mental health disorders and are generally regarded as safe, they usually carry with them side effects and potential consequences. This is especially true for newly emerging psychedelic medicine treatment regimens, such as ketamine to treat depression, MDMA-assisted psychotherapy for PTSD and others.
One company bringing a multifaceted, biological approach to the emerging psychedelic medicine industry is HaluGen Life Sciences. This Canadian technology company was founded by entrepreneur Franco Vigile, along with leading scientists, with the goal of empowering individuals to reduce potential risks and side effects of psychedelic drugs and treatments. The company recently launched the world’s first genetic-based psychedelic pre-screening platform that allows people to evaluate their overall sensitivity and risk profile when using hallucinogenic drugs.
Platforms designed by Genesight, BiogeniQ, HaluGen and others offer a scientific approach to assist in guiding the patient and clinician to optimal treatment outcomes. They are often intelligently designed to accommodate future research findings so that, as more clinical data become available, we can seamlessly integrate additional genetic biomarkers as the data deems relevant.
Engaging Patients, Improving Treatment Outcomes
Giving patients the opportunity to influence their treatment regimen can also empower individuals by improving patient care and reducing the likelihood of risks and side effects. Precision medicine has the potential not only to improve patient outcomes but also to change the way health professionals and patients work together to treat mental health conditions. This is a watershed moment in an unprecedented era of medicine.