Precision Prescribing Can Combat Australia’s Expected Surge In Mental Illness

Social isolation, familial and community disconnection, shock job loss and health fears create the perfect storm for a person who is vulnerable to mental illness. New modelling by the Brain and Mind Centre confirms our fears, that this pandemic may see more deaths by suicide than by the virus itself. Predictions estimate a 25% increase to suicide rates and even higher rates for younger Australians. In our recent submission to the Australian Department of Health, we outlined how precision prescribing and pharmacogenomics could be a a new, and vitally important, dimension in the fight against such a shocking tidal wave of suicide and depression.

Mental illness is a condition that does not care about who it hits or when or what the socio-economic circumstances are for that person but for young people, the impact on them, their families and their future, can be particularly devastating. myDNA has developed a clear and research-driven plan to protect our most vulnerable from self-harm at a time when they are already facing unimaginable emotional and financial stress and uncertainty.

It is a sad fact that even the most experienced specialist or GP must employ a level of guess work when recommending which anti-depressant treatment will work the first time. Studies show, 50% of the time, it will take three or more attempts of prescribing yet another medicine before the right treatment finally settles for that patient. This is because, when it comes to mental health, our genes run interference with how we react to medication.

Trial-and-Error can be costly

one-in-five-pink

1 million AUSTRALIANS

Suffer from depression in any one year1.

one-in-two-pink

50% Of Patients

Respond to the initial treatment with antidepressants2.

one-in-10

1 in 10 People

May process certain medications too slowly, increasing their risk of side effects3.

one-in-three

1 in 3 people

May process certain medications too quickly, increasing their risk of treatment failure3.

PHARMACOGENOMICS AND MENTAL HEALTH TREATMENT

For someone struggling with severe mental illness, this time to get it right can stretch to months and the consequences of inaccurate prescribing, and potentially poor compliance, can be devastating for them and their families. For those forced into self-isolation or who have lost their job; the compounding impacts can quickly multiply.

But we know we have a solution. As leading geneticists, pharmacologists and pharmacists, we have researched and developed a new way of determining the best antidepressant treatment for a patient – any patient – suffering any type of mental health disorder.

How we achieve this is through a genetic test that can reveal a person’s ability to processes and metabolise certain medications. Known as Pharmacogenomics, this test is converted into vital knowledge for a doctor, who can then be certain that the medication they prescribe is personalised and accurate – the first time.

I have had many years’ experience providing genetic counselling and applying genetic tests to improve health. I started to develop pharmacogenomic testing as a very practical method of linking genetics to health and have been providing pharmacogenomics as a pathology service for the last 10 years.

Pharmacogenomics has long term benefits

Reduce the risk of adverse drug reactions

Reduce trial-and-error when prescribing

OFFER A PERSONALISED HEALTHCARE SERVICE

Results have a lifetime relevance

REDUCE WASTED COST ON INEFFECTIVE MEDICATION

fast-track treatment goals

THE SOLUTION

This type of test is now used by Australia’s leading pathology services providing such tests for doctors and support services in pharmacies across the country. We have built the network to educate GPs, pharmacists and the public. The challenge now is in application. Sadly, despite such penetration, it is often still not used in the current treatment of mental health disorders.

Amid fears that this pandemic could spawn a ‘generational mental health crisis,’ pharmacogenomics and with it, precision prescribing, have an important role to play in protecting those Australians struggling with mental illness. We know the return on investment for the patient, their family, their community and the nation at large is incredibly significant. For every dollar spent by the government on subsidising these tests for people with mental health problems, we know the savings are 120 to 1.

Peer-reviewed studies and trials have shown us that genetic testing can reduce the suicide rate as well as expediating a patient’s recovery, through the accurate choice of medication. Not to mention evidence proving Pharmacogenomic tests in particular can deliver significant health budget savings by keeping patients out of emergency departments and public hospital beds and by reducing medicine wastage, as patients abandon wrongly prescribed treatments.

OVER $4,000 SAVED PER PATIENT AFTER 60 DAYS

52% REDUCTION IN HOSPITAL READMISSIONS, WHILE EMERGENCY DEPARTMENT VISITS REDUCED BY 42%

Pharmacogenetic Clinical Study

Marciel A. et al. 2018

Leslie Sheffield, MB.BS, MSc, FRACP, APP

Consultant Clinical Geneticist, Medical Director and Founder

myDNA Life Australia

References

1. BeyondBlue
2. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-17.
3. Hicks JK, Sangkuhl K, Swen JJ, Ellingrod VL, Muller DJ, Shimoda K, et al. Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther. 2017;102(1):37-44.