Re: Looking for Pam regarding DNA test

[Guest guest]

Pam,

Our neurologist in Arizona agreed to a DNA test but only ran one factor

which was Cyp2d6. My daughters blood was drawn locally through Sonora Quest

Labs who sent it to Quest Nichols Institute in California. Of the 2 alleles

in this gene pair, she has only one that is active so she has a reduced

level of activity. The doctor didn't think that had any real impact on what

med we use, but I can't understand that. He has not used this testing before

so I am not ready to just accept his interpretation of this result,

particularly since he only tested one gene when there are others to consider.

Can you tell me what other factors (genes) were tested for your daughter

like C-19 etc. I want him to test ALL relative genes so it actually gives

beneficial results for anxiety meds. I guess I need to be specific so he

orders the right tests next time. Also, is there a chart then that tells you

which drugs to use once you have results?

Holly

Arizona

In a message dated 4/6/2011 10:24:26 A.M. US Mountain Standard Time,

barbnesrallah@... writes:

>

> Barb, thanks so much for your response.

>

> There are so many factors, we also made some changes

> to provide more support at school too.

>

> I will definitely add the vitamin D, our therapist mentioned

> this to me today too.

>

> Our therapist had a patient that went to the Mayo

> Clinic for DNA testing so she recommended it to us,

> she felt our daughter needed a medication change.

> The psychiatrist told me not to waste our money

> but did agree to write the prescription for it.

>

> I had a lot of trust in the Mayo Clinic and they recommend

> it for all their pediatric psychiatric patients. They realize

> kids have more side effects and it is more critical to

> get it right the first time.

>

> I know doctors don't want to recommend this since

> it is not covered by insurance. I read on the Mayo

> Clinic web page that it is an ethical issue, do doctors

> recommend a test that may only be afforded to people

> with money. I don't know how Mayo Clinic deals with that

> issue? Perhaps they cover the cost if the patient is

> actually treated at there hospital. I have

> not received any bill yet from Cincinnati Children's

> Hosptial.

>

> I agree looking at the DNA chart can help on it's own.

>

> Today at the therapist I was telling her when I keep wishing

> that this is going away I get upset when it comes back.

> She said if I can accept this condition and really enjoy her happy

> healthy periods and help her cope with the anxiety and stress as

> it comes along it will be better. We can get through it.

>

> I can do that, especially with such kind support from you and our group.

>

> Thanks you so much,

> Pam

>

> >

>

[Guest guest]

Hi Holly,

I know you are looking for Pam on this, but just thought I'd offer this link to

information on this testing It includes a chart of drugs not to use if the 2D6

pathway is an issue. I had an even better chart with both pathways on it and

all the meds, so you can google to search for one, or maybe Pam has that link.

Here's the link -

http://www.healthanddna.com/healthcare-professional/p450-2d6-genotyping.html

I believe you want to ask for P450 drug sensitivity test/DNA test. From what I

understand, if your son is showing issues with 2D6, then you try meds that use

C19 instead. I think 2D6 is the issue for the majority of people who react

negatively. You can type C19 into the search feature on the website at the

above link.

Good luck with this.

Barb

> >

> > Barb, thanks so much for your response.

> >

> > There are so many factors, we also made some changes

> > to provide more support at school too.

> >

> > I will definitely add the vitamin D, our therapist mentioned

> > this to me today too.

> >

> > Our therapist had a patient that went to the Mayo

> > Clinic for DNA testing so she recommended it to us,

> > she felt our daughter needed a medication change.

> > The psychiatrist told me not to waste our money

> > but did agree to write the prescription for it.

> >

> > I had a lot of trust in the Mayo Clinic and they recommend

> > it for all their pediatric psychiatric patients. They realize

> > kids have more side effects and it is more critical to

> > get it right the first time.

> >

> > I know doctors don't want to recommend this since

> > it is not covered by insurance. I read on the Mayo

> > Clinic web page that it is an ethical issue, do doctors

> > recommend a test that may only be afforded to people

> > with money. I don't know how Mayo Clinic deals with that

> > issue? Perhaps they cover the cost if the patient is

> > actually treated at there hospital. I have

> > not received any bill yet from Cincinnati Children's

> > Hosptial.

> >

> > I agree looking at the DNA chart can help on it's own.

> >

> > Today at the therapist I was telling her when I keep wishing

> > that this is going away I get upset when it comes back.

> > She said if I can accept this condition and really enjoy her happy

> > healthy periods and help her cope with the anxiety and stress as

> > it comes along it will be better. We can get through it.

> >

> > I can do that, especially with such kind support from you and our group.

> >

> > Thanks you so much,

> > Pam

> >

>

> > >

> >

>

>

>

>

>

>

>

>

[Guest guest]

If you are near MN you can go to the Mayo Clinic, they are the

leaders in this area.

Only testing CD6 tells you she is an intermediate metabolizer

of drugs like prozac and rispedal.

My daughter was an intermediate metabolizer of c19 (ie. zoloft is in this class)

and an extensiver metabolizer of cd6 (prozac).

She was not getting better on zoloft so I asked for the DNA

test, through Cininnati Children's Hospital. I got the

results from the psychiattrist and asked to try " prozac "

which we did and I see that she is responding better

to this medication. Our psychiatrist was not for this

test (it is not covered by insurance) but the concept is

not hard to understand, if there is a choice pick the

medication that your child metabolizers better.

That is what I did.

Cincinnati Children's hospital tests a few genes, c19, cd6

Genelex at healthanddna.com tests a whole list of genes

for drug sensitivity, for SSI's the primary pathways

are c19, cd6 and c9. Many drugs have a primary pathway

(ie zoloft is c19 but also the drugs goes through

other pathways too).

It makes sense to me to make sure the primary pathways

are good metabolizers.

What medications are you interested in?

http://www.healthanddna.com/drug-safety-dna-testing/dna-drug-reaction-testing.ht\

ml

Pam

, maj4fam@... wrote:

>

> Pam,

> Our neurologist in Arizona agreed to a DNA test but only ran one factor

> which was Cyp2d6. My daughters blood was drawn locally through Sonora Quest

> Labs who sent it to Quest Nichols Institute in California. Of the 2 alleles

> in this gene pair, she has only one that is active so she has a reduced

> level of activity. The doctor didn't think that had any real impact on what

> med we use, but I can't understand that. He has not used this testing before

> so I am not ready to just accept his interpretation of this result,

> particularly since he only tested one gene when there are others to consider.

>

> Can you tell me what other factors (genes) were tested for your daughter

> like C-19 etc. I want him to test ALL relative genes so it actually gives

> beneficial results for anxiety meds. I guess I need to be specific so he

> orders the right tests next time. Also, is there a chart then that tells you

> which drugs to use once you have results?

> Holly

> Arizona

>

>

> In a message dated 4/6/2011 10:24:26 A.M. US Mountain Standard Time,

> barbnesrallah@... writes:

>

>

> >

> > Barb, thanks so much for your response.

> >

> > There are so many factors, we also made some changes

> > to provide more support at school too.

> >

> > I will definitely add the vitamin D, our therapist mentioned

> > this to me today too.

> >

> > Our therapist had a patient that went to the Mayo

> > Clinic for DNA testing so she recommended it to us,

> > she felt our daughter needed a medication change.

> > The psychiatrist told me not to waste our money

> > but did agree to write the prescription for it.

> >

> > I had a lot of trust in the Mayo Clinic and they recommend

> > it for all their pediatric psychiatric patients. They realize

> > kids have more side effects and it is more critical to

> > get it right the first time.

> >

> > I know doctors don't want to recommend this since

> > it is not covered by insurance. I read on the Mayo

> > Clinic web page that it is an ethical issue, do doctors

> > recommend a test that may only be afforded to people

> > with money. I don't know how Mayo Clinic deals with that

> > issue? Perhaps they cover the cost if the patient is

> > actually treated at there hospital. I have

> > not received any bill yet from Cincinnati Children's

> > Hosptial.

> >

> > I agree looking at the DNA chart can help on it's own.

> >

> > Today at the therapist I was telling her when I keep wishing

> > that this is going away I get upset when it comes back.

> > She said if I can accept this condition and really enjoy her happy

> > healthy periods and help her cope with the anxiety and stress as

> > it comes along it will be better. We can get through it.

> >

> > I can do that, especially with such kind support from you and our group.

> >

> > Thanks you so much,

> > Pam

> >

>

> > >

> >

>

>

>

>

>

>

>

>

[Guest guest]

Hi Pam,

How is your daughter doing these days? So glad to hear that the prozak is

working out better.

Warmly,

Barb

>

> If you are near MN you can go to the Mayo Clinic, they are the

> leaders in this area.

>

> Only testing CD6 tells you she is an intermediate metabolizer

> of drugs like prozac and rispedal.

>

> My daughter was an intermediate metabolizer of c19 (ie. zoloft is in this

class) and an extensiver metabolizer of cd6 (prozac).

>

> She was not getting better on zoloft so I asked for the DNA

> test, through Cininnati Children's Hospital. I got the

> results from the psychiattrist and asked to try " prozac "

> which we did and I see that she is responding better

> to this medication. Our psychiatrist was not for this

> test (it is not covered by insurance) but the concept is

> not hard to understand, if there is a choice pick the

> medication that your child metabolizers better.

>

> That is what I did.

>

> Cincinnati Children's hospital tests a few genes, c19, cd6

>

> Genelex at healthanddna.com tests a whole list of genes

> for drug sensitivity, for SSI's the primary pathways

> are c19, cd6 and c9. Many drugs have a primary pathway

> (ie zoloft is c19 but also the drugs goes through

> other pathways too).

>

> It makes sense to me to make sure the primary pathways

> are good metabolizers.

>

> What medications are you interested in?

>

>

http://www.healthanddna.com/drug-safety-dna-testing/dna-drug-reaction-testing.ht\

ml

>

>

> Pam

>

[Guest guest]

She is doing better Barb. Prozac is not activiting for her as the

zoloft was. When my daughter gets sick (usually a sinus infection)

it triggers a very irritable mood, obsessive and aggressive mood.

I still have to see how she holds up on prozac. I expect she

will need the medication increased and then we will see if she

can manage an increase again. 10mg is what she is on, it's low

but she was very sensitive to zoloft increases I have

to see what happens on prozac.

Overall though she has improved in that she can talk about her

problems more in a way that she never could before. I will have

to see with behavior therapy and cognitive therapy will she

improve more or perhaps we need another increase. She still

has obsessive thoughts and outbursts.

Today we were at a church activity and I suggested we walk

around and talk to kids her age. She didn't want to, but in the car she could

tell me the reasons she was anxious. And I could

tell her why I thought it was important to try anyway. She was

still upset when we got home, but she got over it quickly.

This is an improvement over biting me, pulling my hair

(and she is 13) when she is anxious.

I am very happy I made the change, based on the DNA test.

Our therapist and child psychiatrist were suggesting

lexapro. It could have worked but lexapro is a c19 drug

which is like zoloft and she does not metabolize c19 as

well as c6. The DNA test helped me keep going with another

trial. The psychiatrist was also suggesting Abilify which

may have worked well too, but I just knew that antidepressants

are the first choice for obessiveness.

thanks again for asking. This group has been so helpful to me.

Pam

> >

> > If you are near MN you can go to the Mayo Clinic, they are the

> > leaders in this area.

> >

> > Only testing CD6 tells you she is an intermediate metabolizer

> > of drugs like prozac and rispedal.

> >

> > My daughter was an intermediate metabolizer of c19 (ie. zoloft is in this

class) and an extensiver metabolizer of cd6 (prozac).

> >

> > She was not getting better on zoloft so I asked for the DNA

> > test, through Cininnati Children's Hospital. I got the

> > results from the psychiattrist and asked to try " prozac "

> > which we did and I see that she is responding better

> > to this medication. Our psychiatrist was not for this

> > test (it is not covered by insurance) but the concept is

> > not hard to understand, if there is a choice pick the

> > medication that your child metabolizers better.

> >

> > That is what I did.

> >

> > Cincinnati Children's hospital tests a few genes, c19, cd6

> >

> > Genelex at healthanddna.com tests a whole list of genes

> > for drug sensitivity, for SSI's the primary pathways

> > are c19, cd6 and c9. Many drugs have a primary pathway

> > (ie zoloft is c19 but also the drugs goes through

> > other pathways too).

> >

> > It makes sense to me to make sure the primary pathways

> > are good metabolizers.

> >

> > What medications are you interested in?

> >

> >

http://www.healthanddna.com/drug-safety-dna-testing/dna-drug-reaction-testing.ht\

ml

> >

> >

> > Pam

> >

>

[Guest guest]

When I have some time later I will look at the book

I have on the other psychiatry DNA genes and she what Mayo Clinic suggests

beyond C19, c9 and 2D6.

Pam

> >

> > Barb, thanks so much for your response.

> >

> > There are so many factors, we also made some changes

> > to provide more support at school too.

> >

> > I will definitely add the vitamin D, our therapist mentioned

> > this to me today too.

> >

> > Our therapist had a patient that went to the Mayo

> > Clinic for DNA testing so she recommended it to us,

> > she felt our daughter needed a medication change.

> > The psychiatrist told me not to waste our money

> > but did agree to write the prescription for it.

> >

> > I had a lot of trust in the Mayo Clinic and they recommend

> > it for all their pediatric psychiatric patients. They realize

> > kids have more side effects and it is more critical to

> > get it right the first time.

> >

> > I know doctors don't want to recommend this since

> > it is not covered by insurance. I read on the Mayo

> > Clinic web page that it is an ethical issue, do doctors

> > recommend a test that may only be afforded to people

> > with money. I don't know how Mayo Clinic deals with that

> > issue? Perhaps they cover the cost if the patient is

> > actually treated at there hospital. I have

> > not received any bill yet from Cincinnati Children's

> > Hosptial.

> >

> > I agree looking at the DNA chart can help on it's own.

> >

> > Today at the therapist I was telling her when I keep wishing

> > that this is going away I get upset when it comes back.

> > She said if I can accept this condition and really enjoy her happy

> > healthy periods and help her cope with the anxiety and stress as

> > it comes along it will be better. We can get through it.

> >

> > I can do that, especially with such kind support from you and our group.

> >

> > Thanks you so much,

> > Pam

> >

>

> > >

> >

>

>

>

>

>

>

>

>

[Guest guest]

There is so much information in the book " Psychiatric Pharmogenetics "

by Dr. Mrazek, Chair of Psychiatry at the Mayo Clinic, MN.

The book is written for doctors, but I found it very easy to read,

there is a summary at the end of each chapter.

First about your daughter's results, what did the lab report

say her actually allele pair is. It will be on the report.

It will look like this: 2D6 *1 *1 (normal metabolizer)

And what medications are you interested in knowing how

she responds too.

From this book, it looks like 2D6, C19 and 2C9 are primary

pathways for many psychiatric and seizure drugs.

Also 1A2 is primary path for paxil, and for medications for

schizophrenia like clozapine, olanzapine.

Pam______________________________________________________

Then there are 11 other genes that may explain some of the cases of

poor responders when there primary pathways are fine.

These tests seem to be conducted still

in research primarily. The Mayo Clinic may run this

tests for trying to understand nonresponders.

COMT gene : more of use for nonresponder schizophenic patients.

SLC6A2 gene: for poor responders to SSI antidepressants. May

test this gene to determine if TCA antidepresants will work.

SLC6A3: predicting amphetamine response.

SLC6A4: may explain poor response.

HTR1A: may explain poor response.

HTR2A: may explain poor respose.

HTR2C: may predict weight gain in use of antipsychotic drugs.

DRD2: may predict side effects and risk of neuroloeptic melignant

syndrome in antipsychotic use.

DRD3: more research needed

DRD4: predicts response to ADHD medication

> >

> > Barb, thanks so much for your response.

> >

> > There are so many factors, we also made some changes

> > to provide more support at school too.

> >

> > I will definitely add the vitamin D, our therapist mentioned

> > this to me today too.

> >

> > Our therapist had a patient that went to the Mayo

> > Clinic for DNA testing so she recommended it to us,

> > she felt our daughter needed a medication change.

> > The psychiatrist told me not to waste our money

> > but did agree to write the prescription for it.

> >

> > I had a lot of trust in the Mayo Clinic and they recommend

> > it for all their pediatric psychiatric patients. They realize

> > kids have more side effects and it is more critical to

> > get it right the first time.

> >

> > I know doctors don't want to recommend this since

> > it is not covered by insurance. I read on the Mayo

> > Clinic web page that it is an ethical issue, do doctors

> > recommend a test that may only be afforded to people

> > with money. I don't know how Mayo Clinic deals with that

> > issue? Perhaps they cover the cost if the patient is

> > actually treated at there hospital. I have

> > not received any bill yet from Cincinnati Children's

> > Hosptial.

> >

> > I agree looking at the DNA chart can help on it's own.

> >

> > Today at the therapist I was telling her when I keep wishing

> > that this is going away I get upset when it comes back.

> > She said if I can accept this condition and really enjoy her happy

> > healthy periods and help her cope with the anxiety and stress as

> > it comes along it will be better. We can get through it.

> >

> > I can do that, especially with such kind support from you and our group.

> >

> > Thanks you so much,

> > Pam

> >

>

> > >

> >

>

>

>

>

>

>

>

>