Recently I decided to switch my psychiatrist from a wonderful person who has been my psychiatrist since I was sixteen years old to a Psychiatric Nurse Practitioner because the Nurse Practitioner takes my specific health insurance.  I have been paying out of pocket and cannot afford the $150 per session.  I was skeptical about seeing a new professional but finances have forced me this way.  When I went in for my first appointment last week my new Psych NP said that my insurance covers a thing called GeneSight testing.  She explained that GeneSight testing requires a swab on the inside of my mouth and then she sends that sample into the lab.  within 10 days we will get a list of medications and how my genes respond to these medications.  We will determine the best medication for my symptoms of Bipolar disorder based on my own genes!  I thought this was pretty cool.  In fact I got a little teary eyed from relief that there is some scientific backing to all of this medication as it pertains to me personally.  Typically the way a psychiatrist administers medication to a person with a psychiatric illness is literally by trial and error based on scientific studies.  The problem I have always had with this is that the studies were not done on me so how can I be sure that the medication is the best for ME.  I am very interested to see what the results are.  I will of course report them here on my blog.
I am going to further explain my experience of how psychiatric medications are administered through the use of a metaphor.  Imagine working on a car and knowing that it has problem symptoms but because you don’t have it hooked up to a data collecting machine like a DYNA which reads misfires, horsepower, torque etc.  So you really have to guess what is wrong and how to fix it.  would you expect your mechanic to pour some liquid into the engine and tell you that he/she thinks this may solve the issue?  Even though pouring this liquid into most cars usually fixes this type of car trouble, it may not fix yours but are you okay if they pour it in anyway? you may get some terrible things happening with your car, side effects can be damaging but can I pour it in anyway? You would probably walk out and want your money back or you would feel really uncomfortable watching your mechanic pour this liquid into your car’s engine.  This is how psychiatry typically works.  You are given a medication and told to come back and report how you feel after the medication sets in.  If you come back and all is good then you stay on that dose.  If you come back and you have terrible side effects they will typically change the medication.  If you come back and things aren’t the best but the side effects are tolerable they will increase or decrease your dose on the same medication.  Does this sound scientific or scary?
You can imagine my relief when the Psych NP told me there is a scientific way to figure out the best medication for my Bipolar disorder symptoms.  It was partially relief that I may find a medication that does not have the side effects that I experience on a daily basis, and partially that I may find a medication that gives me a relief from the Mania and the depression and the fear of not knowing what each day is going to feel like.
Thomas