Mayo Clinic Offers New Genetic Test to Help Manage Treatment for Patients with Depression

By John M Grohol PsyD

Beware!

Mayo Clinic is offering a new genetic test to help physicians identify patients who are likely to have side effects from drugs commonly used to treat depression.

Mayo has obtained a nonexclusive license from Pathway Diagnostics, Inc. to test for a key genetic marker that identifies people who respond differently to antidepressants, including selective serotonin reuptake inhibitors (SSRI). SSRIs act specifically by binding to the serotonin transporter, and increase the concentration of the neurotransmitter serotonin in the synapse. These medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa) and escitalopram (Lexapro). The test will be offered to patients nationwide through Mayo Medical Laboratories (MML), the reference laboratory for Mayo Clinic.

A 2003 study in the Journal of Clinical Psychiatry estimated the annual economic impact of depression in the Unites States at $83.1 billion, and one of six Americans will have at least one depression episode in their lifetime. Treatment choices are complicated because it often takes several weeks to determine whether a drug is having a therapeutic effect. The 5HTTLPR biomarker has potential to improve management of patients with major depression and others who benefit from SSRI treatment. It provides unique information relating to drug response: side effect and compliance.

What’s the harm?

The harm is that once a company (insurance company/clinic/hospital/doctor/etc.) has your genetic profile — or, in this case, the result of a specific genetic test — they can use that not only to help you (as the Mayo Clinic is proposing), but also for nefarious reasons: to drop coverage, raise coverage prices, or deny future coverage, life insurance policies, etc.

You should beware when any company is (a) asking you for personal health information and (b) they are trying to sell you related health products, such as health insurance, because there is an inherent conflict of interest between the two. A company cannot in good conscious try and help you lead a healthier, better life, and at the same time, offer to insure you. The former informs the latter, and then the latter will react accordingly (deny coverage, offer insurance at a higher premium, etc.).

Genetic testing? No thanks, not now, not ever. Not until the treatments are so well-proven to help save my life or better my health that the benefits are a clear positive over the risks for personal harm.

Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992.