genesight-review

GeneSight review – Can DNA testing help your mental health?

Rating based on out GeneSight review

7 facts from our GeneSight Review

  1. GeneSight location: Ohio, USA
  2. Products: clinical genomic test for psychotropics
  3. Reports: gene-drug interactions for psychiatric medication
  4. Result delivery: reports are delivered by a doctor, typically within days
  5. Privacy: data not deleted per default, users must email the customer service
  6. Cost: the majority of users pay less than $330; some are covered by insurance, some may pay more
  7. Alternatives: Nebula Genomics (whole genome sequencing for $299), GenoMind, GeneCept and CNSDose

Introduction

This is a review of GeneSight, a diagnostic DNA test from Myriad Genetics. Reports focus exclusively on genes relevant to psychotropic medications. 

The company offers DNA testing to better understand drug interactions for mental health conditions. This can help patients find the right drug that improves their mental health and save months or years of painful trial and error to find the right medication. 

GeneSight’s product is backed by seven peer-reviewed clinical studies. One study showed higher remission rates among those who took the GeneSight test.

As a clinical pharmacogenomics test, it works differently than other DNA tests like 23andMe and AncestryDNA. The GeneSight test focuses exclusively on analyzing gene-drug interactions to identify the best treatments for mental health conditions.

Do you have depressive symptoms? GeneSight markets their test for people who require treatments for conditions including:

  • Depression or Major depressive disorder
  • Anxiety
  • Mood disorders

Another major difference is that it is a clinical test. DNA samples are collected at a doctor’s office. Test results are reviewed by the medical staff. Patients can follow up with a doctor to discuss results.

According to the GeneSight website, 1 million individuals have taken the test. 

The science behind GeneSight

GeneSight claims that its test is backed by more scientific evidence than any other pharmacogenomics test. They mention 7 clinical studies on their homepage.

Pharmacogenomics refers to the use of genomic sequencing in order to better prescribe medicine. In this case, GeneSight seeks to analyze gene-drug interactions to identify the most effective psychotropics.

This field has been growing for quite some time, and the research supporting the use of genetics to prescribe psychotropics has been debated, depending on the condition. For some mental disorders, there is only scarce evidence, but for others, there has been more success connecting genomics to drug metabolism.

A 2015 review by The Carlat Report of GeneSight’s clinical evidence concluded that the evidence at that point was not entirely convincing, but intriguing. The author suggested that psychiatrists reserve use of the test for patients who have unsuccessfully tried multiple medications.

A similar conclusion arose in a STAT News report of a different pharmacogenetic service. In an editorial published in JAMA Psychiatry, authors suggest that diet and demographic information may be more important than genetics in determining drug metabolism — leading to their conclusion that the test may not warrant the cost.

However, more recently, GeneSight has published more studies. One such study from 2019 shows statistically significant improvements in inpatient drug response based on the provided recommendations.

Taking the GeneSight Test

Step-by-step instructions are provided on the website. The process begins with a cheek swab to collect a DNA sample. GeneSight is not an at-home test, so this sample collection is done by a doctor. The doctor then sends this sample to the GeneSight lab for analysis.

From the moment GeneSight receives a sample, they complete their analysis within 36 hours. After the sample processing, they send the test results to the doctor who collected the sample. The doctor can then consult with GeneSight to understand the report before communicating the results to the patient.

GeneSight Genetic Counseling

GeneSight’s test must be ordered by a healthcare provider after genetic counseling. The cost of this genetic consultation is not included in the price of the service. 

Health insurance will typically cover genetic counseling, but it depends on tested genes. Otherwise, such appointments (without testing) could cost hundreds of dollars.

GeneSight helps patients to find a healthcare provider in their area to order the test. It recommends consulting with a psychiatrist or primary care physician. 

Review of GeneSight Report Details

GeneSight provides a sample report for patients to review before purchasing their service. The official name is Psychotropic – Combinatorial Pharmacogenomic Test

The 9-page sample report begins with 4 pages of results for 4 different types of psychotropics, examples of which can be found in the table below.

Drug TypeDrug NameBrand Name
AntidepressantsDesipramineNorpramin
SertralineDesyrel
TrazodoneZoloft
Anxiolytics & HypnoticsLorazepamAtivan
EszopicloneLunesta
AlprazolamXanaxAnti
AntipsychoticsAsenapineSaphris
ChlorpromazineThorazine
AripiprazoleAbilify
Mood StabilizersDivalproexDepakote
LamotrigineLamictal

On each of these pages, the report bins individual medications into separate categories. The categories are:  “Use as directed”, “Moderate gene-drug interaction”, or “Significant gene-drug interaction”.

Let’s review a GeneSight report. In this sample report, we can see that the patient can use Norpramin as directed. The patient may have moderate gene-drug interactions with Desyrel and significant interaction with Zoloft.

Example of GeneSight’s report on drug interactions with antidepressants.
Example of GeneSight’s report on drug interactions with antidepressants.

For more detailed information, the report provides numbered codes next to each drug. For example, we can learn more about the possible interaction with Zoloft with codes 1, 4, 6. 

According to a key at the bottom of the page, we see that lower doses may be required (1). We can also learn that the drug may be less effective (4) and that the patient may encounter a greater risk of side effects (6).

Key for understanding the GeneSight report results.
Key for understanding the report results.

The other 3 reports have the same structure. We can see that the patient may not be able to take any anxiety medication as directed (Figure 3). 

Page 2 of the GeneSight report that focuses on anxiety medication.
Page 2 of the report that focuses on anxiety medication.

The Mood Stabilizers page has fewer drugs listed. That page also has an extra box for drugs that have “no proven genetic markers.” This is how GeneSight shares that Topamax and lithium are not compatible with their report.

GeneSight mood stabilizers report.

Page 5 of the report details the patient’s “pharmacodynamic genes.” These genes may affect how the body responds to a medication. In this case, the patient has a genetic variant (SLC6A4). This polymorphism, according to GeneSight, may decrease the effectiveness of SSRIs which are a common type of antidepressant.

Pharmacodynamic genes in the GeneSight report. 

Page 6 of the report looks at the patient’s “pharmacokinetic genes”. These genes may affect how the body metabolizes drugs. In this case, the patient has a genetic variant (CYP1A2). This genotype, according to GeneSight, may make the patient an “ultrarapid metabolizer” of some drugs.

Pharmacokinetic genes in the GeneSight report.

The report then moves on to pages 7 and 8. These pages detail which drugs interact with which genes. This analysis is again broken into sections, “Use as directed”, “Moderate gene-drug interaction”, or “Significant gene-drug interaction”.

Filled circles indicate interaction, empty circles indicate that the patient’s genotype is “normal”. The patient in the sample report may have poor metabolism due to a variant in gene CYP3A4. According to GeneSight, this results in significant gene-drug interaction for Xanax.

Some examples of GeneSight’s gene-drug interactions table.
Some examples of GeneSight’s gene-drug interactions table.
More examples of GeneSight’s gene-drug interactions table.
More examples of gene-drug interactions table.

The final page of the report just provides a record of test information. It also indicates that the test was reviewed and verified by a clinical scientist. GeneSight reiterates that “all psychotropic medications require clinical monitoring”. This means that the GeneSight report does not replace a doctor but can help a doctor prescribe the right medication. 

Review of GeneSight Costs

According to GeneSight, the majority of patients pay $330 or less. GeneSight claims that they will call patients if their test will cost more than $330. It is worth noting that this cost may not include copays for medical visits. The reported cost is only for the GenSight test itself depends on your insurance provider.

  • Medicaid or Medicare: Traditional plans cover the testing in full.
  • Medicare Advantage: Typically $330 or less. GeneSight claims to contact patients if costs will exceed $330.
  • Employer/commercial providers: Typically $330 or less. GeneSight claims to contact patients if costs will exceed $330  (same as Medicare Advantage).
  • No insurance: More than $330, typically. Some patients may qualify for financial assistance.

After GeneSight receives the DNA sample, they calculate a patient’s out-of-pocket cost. If that cost exceeds the $330, GeneSight will contact patients before billing insurance and proceeding. GeneSight submits insurance claims after processing samples. 

Patients then receive an explanation of benefits from their insurance company, before finally receiving a bill.

Review of GeneSight Privacy & Data

Is GeneSight safe?  Myriad Genetics has a Notice of Privacy Practices that explains what personal information the company collects from patients. According to this notice, GeneSight collects email addresses, names, addresses. They also collect personal and family health history, insurance, employment, and demographic information. 

GeneSight uses data for promotional and marketing efforts such as social media advertising. Patients can request that their data be deleted.

Will GeneSight disclose your personal data to third parties? This company will share personal information with certain third parties. Myriad insists that these third parties must comply with their privacy policy.

GeneSight In the News

GeneSight Reviews

GeneSight Pros/Cons

Pros

  • Specifically tailored to psychiatric medication 
  • Offers a diagnostic test with sign-off from doctors
  • Can be covered by insurance
  • Can save patients trial and error for selecting medications

Cons

  • More expensive than whole genome sequencing
  • A lot of very personal is collected and shared 
  • Can’t upload genomic data from other providers

Nebula Genomics

We finish our GeneSIght review by comparing it to Nebula Genomics and other DNA testing companies.

With 30x Whole-Genome Sequencing (WGS), Nebula Genomics decodes 100% of your DNA for only $299. WGS lets us provide the most comprehensive reporting and weekly research updates to empower users with information. In contrast, GeneSight sequences just a few dozen genes and charges for that more than $330. 

Although Nebula does not offer a diagnostic test, our results are produced in clinical-grade (CLIA/CAP-accredited) labs. That means healthcare providers trust the quality of our lab operations and genomic information. Users with Nebula results can bring their genome data to healthcare providers or genetic counselors for further consultation. If you have a known genetic disorder in your family history, please consult with your healthcare provider first.

Here is how GeneSight compares with other DNA testing companies.


23andMeAncestryNebula GenomicsGeneSight
Type of Genome Reporting ServiceMicroarray-based genotypingMicroarray-based genotyping Whole-Genome Sequencing (30x coverage)Unclear which technology is used
Produced data~ 600,000 positions in the genome~ 700,000 positions in the genome~ 3,000,000,000 positions in the genomeGene-drug interactions for a dozen of genes
Compatible with other sitesCan export data and use it elsewhere.Can export data and use it elsewhere.Can export data and use it elsewhere.Not compatible with other services
Works with insuranceNoNoNoYes
Weekly UpdatesNoNoYes (Nebula Research Library)No
Ancestry ReportingYesYesYesNo
Cost$99, $199, or $499$99 or $149$0 – $299Often less than $330. Will notify you if more.

GeneSight vs Ancestry vs 23andMe vs Nebula Genomics

Did you like our GeneSight review? More reviews can be found here. If you are looking for clinical genetic testing, take a look at our Invitae, Myriad Genetics, Color Genetics, and Ambry Genetics reviews.

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