Genetic testing for ADHD medication

Genetic Testing for ADHD

by Melissa Smith, PharmD, CPH

Have you or your children ever experienced challenges with focus, impulsivity, inability to gather thoughts in the course of everyday life? Has the question ever surfaced that there may be a medical diagnosis to explain these symptoms? Attention deficit/ hyperactivity disorder (ADHD) may be the culprit for these disrupted symptoms. In 2016 the Center for Disease Control (CDC) conducted a national survey finding that 6.1 million (9.4%) of children in the United States have been diagnosed with (ADHD).[1] In a National Comorbidity Survey Replication (NCS-R) conducted in 2003 it estimated that the prevalence of adults in the United States that are 18-44 years of age make up 4.4% of the adult population. In addition, that adult population was found to have a 5.4% prevalence in males, and a 3.2% prevalence in females.[2]To help counteract the effects of ADHD, more and more people are turning toward prescription medications.

When introducing a new drug into the body, there’s always the chance that one’s body will react negatively such as experiencing side effects.

While this can be an effective way to manage the symptoms of ADHD, it can also be harmful. The Mindwell test from ClarityX provides an extensive overview of ADHD medications that can be affected by an individual’s genetics. The results can provide a roadmap on where to begin with prescription medications based on a person’s individual genetic profile. This can essentially lessen the burden of cost and unwanted side effects a person can experience when beginning treatment.

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What Types of ADHD Medications Are There?

According to the National Survey of Children’s Health (NSCH), in children diagnosed with ADHD there is approximately 69.3% that are on a medication-based treatment compared to no treatment at all.[3] Medication treatment for adults traditionally begins with initial treatments with stimulants for their ADHD diagnosis. Results from a 2018 National Survey in drug use and health indicated that approximately 1 million people that were 12 years of age and older have misused prescription stimulants over the course of a year.[4] All the more reason for providers to have access to information about their patients to find the right ADHD medication for initial therapy.

ADHD Medication Options

While medication can help mitigate the effects of ADHD, it can be difficult to choose the most appropriate ADHD medication. Patients are presented with an overwhelming number of options, most of which fall into one of two categories of stimulants or non-stimulant.

The most common first-line therapy is stimulants when treating ADHD. It is a fast-acting drug that targets the chemical dopamine receptors in the brain to reduce symptoms like hyperactivity, impulsivity, and lack of focus. Stimulants have an abundance of supporting evidence that shows their effectiveness when treating ADHD in all patient populations. However, they can produce side effects such as appetite suppression, insomnia, and irritability. Stimulants are also a Class II Controlled Substance that can be habit forming and has a high probability of being abused. Some examples of common stimulant drugs used to treat ADHD are amphetamine salts (Adderall), methylphenidate (Ritalin), lisdexamphetamine (Vyvanse), and dexmethylphenidate (Focalin).[5]

A relatively new option for the treatment on ADHD is non-stimulants. The options available target different receptors in the brain that help to treat symptoms of ADHD. It is currently unknown exactly how non-stimulants work in the body to treat ADHD symptoms but have been found in clinical practice to help alleviate the symptoms experienced with patients with ADHD. Examples include atomoxetine (Strattera), guanfacine (Intuniv), and clonidine (Kapvay). Since these generally take longer to show improvement of ADHD symptoms they fall into the second line of therapy when providers are making decisions.[6]

How Are ADHD Medications Prescribed?

When it comes to selecting a specific type of drug (such as Adderall or Ritalin), most doctors will begin the process of trial and error. A certain drug may be prescribed based on factors such as age, metabolic panels, and medical history. Those factors are considered, and medications are adjusted if the patient experiences side effects or no benefit at all. This process can be time consuming, costly to the patient, and can lead to a slew of negative side effects. Some examples of those side effects include trouble sleeping, decreased appetite, weight loss, increased blood pressure, headaches, stomach aches, moodiness, and irritability. Side effects can occur because the patient is on the wrong dosage or doesn’t follow their doctor’s instructions. However, in many cases, patients have no control over how their body will respond to a drug. Pharmacogenetic (PGx) testing can shed light on how a person can react to medications and provide a good direction on where to begin.

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How Do Genetics Influence Drug Metabolism?

Deoxyribonucleic acid (DNA) is where genes are inherited from our parents. It is easiest to think of DNA as a code that utilizes the letters A, C, G, and T to comprise its many genes. Different combinations of these letters signify the instructions those genes used to produce proteins in the body. Proteins are made up of amino acids sequenced from a corresponding gene. Proteins carry out many different functions of the body and one of those functions is the breakdown (metabolization) of medications. The presence of genetic variations in the genes can impact the instructions needed to produce these enzymes, affecting how individuals respond to medications. These enzymes are commonly known as Cytochrome P450 (CYP450) enzymes. [7]

The same way that every person looks different, everybody’s CYP450 enzymes react differently with certain drugs. While one individual may be able to metabolize a medication with ease, another might struggle to break down the substance. When an enzyme reacts too quickly, the drug does not have the chance to be effective. Conversely, when it reacts too slowly, the drug is left in the body and causes harmful side effects.

While we cannot necessarily control our genes, we can learn more about them. Pharmacogenetic (PGx) testing for ADHD medications examines how a person’s CYP450 enzymes metabolize certain medications, allowing providers to make more informed, effective choices on medications to use with their patients.

How Are Pharmacogenetic (PGx) Testing Results Used?

Pharmacogenetic testing examines your genes to identify any mutations that may impact how certain drugs work in the body. In general pharmacogenetics focuses on genes that encode specific CYP450 enzymes that affect the metabolism of over 70% of clinically used drugs. Genetic testing for ADHD medications is an easy straightforward process. The Mindwell test from ClarityX provides a seamless in-home testing experience. Simply visit the website clarityxdna.com, select the Mindwell test option from the drop-down menu and complete the checkout process. Once the kit is received follow the package instructions, perform a simple cheek swab, then mail the sample back using the prepaid envelope. The sample is then sent to the lab for processing and the results are posted in your clarityx patient portal in 7-14 days on average. One of the most important facts about pharmacogenetic (PGx) testing is the results can be reevaluated for future medication changes as this test does not have to be repeated for those specific genes tested. Another key function of the Mindwell test is specific medications can be entered to be evaluated to see how an individual’s genetic make-up can affect those therapies.

Benefits of Pharmacogenetic (PGx) Testing for an ADHD Treatment Plan

Anyone can benefit from a genetic test for ADHD medications. PGx testing should be considered if the following applies to you: current medication is ineffective, currently struggling with the trial-and-error approach your provider is using, prone to experiencing side effects on medications, and underlying medical conditions. Pharmacogenetic (PGx) testing can provide a lifetime of knowledgeable decisions about medication selection for health care teams. When trial and error isn’t practical or simply too time-consuming and inconvenient, pharmacogenetic (PGx) testing for ADHD medications can help providers prescribe proper dosages and determine which drugs will have the most benefit or potentially cause the most side effects. Having the proper ADHD medication along with its appropriate dosage can have a huge impact for those suffering with ADHD symptoms.

Get Tested for ADHD Medications Today!

Treating your ADHD effectively can be difficult, especially when you don’t even know which ADHD medications are right for you. PGx testing can help narrow down medication options and guide the selection of treatments that are best suited for a patient’s overall health.

ClarityX, believes that every person with ADHD deserves immediate access to high-quality treatment. There is no reason why you should experiment with different drugs and put yourself through a myriad of side effects just to find a medication that works for you.

ClarityX offers the Mindwell PGx test that examines your genetic variations and helps pinpoint the best medication for you. Click the Get Started button to find out more!

Ordered by over 2000+ Physicians for their patients

Citations

[1]https://www.cdc.gov/ncbddd/adhd/data.html

[2] Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, Faraone SV, Greenhill LL, Howes MJ, Secnik K, Spencer T, Ustun TB, Walters EE, Zaslavsky AM. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006 Apr;163(4):716-23. PMID: 16585449

[3] U.S. Department of Health and Human Services. (n.d.). Attention-deficit/hyperactivity disorder (ADHD). National Institute of Mental Health. Retrieved May 6, 2022, from https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd#part_2552

[4] Key substance use and mental health indicators in the United States … (n.d.). Retrieved May 6, 2022, from https://www.samhsa.gov/data/sites/default/files/reports/rpt35319/2020NSDUHFFR1PDFW102121.pdf

[5] U.S. Department of Health and Human Services. (n.d.). Attention-deficit/hyperactivity disorder in adults: What you need to know. National Institute of Mental Health. Retrieved May 6, 2022, from https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know

[6] U.S. Department of Health and Human Services. (n.d.). Attention-deficit/hyperactivity disorder in adults: What you need to know. National Institute of Mental Health. Retrieved May 6, 2022, from https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know

[7] https://www.pharmgkb.org/whatIsPharmacogenomics

Medications Covered On The Genetic Test for ADHD Medications

Brand	Generic
Intuniv	Guanfacine
Strattera	Atomoxetine
Ritalin, Aptensio, Concerta, Metadate, Quillivant	Methylphenidate
Focalin	Dexmethylphenidate
Adderall, Evekeo	Amphetamine
Vyvanse	Lisdexamfetamine