GeneSight review – Can genetic testing help your mental health?

GeneSight Review Summary

GeneSight is a genetic testing company that provides DNA-based recommendations for mental health medication. Read more in our GeneSight review!

Nebula Genomics

Results

Price

Comprehensiveness

Summary

Genesight is a clinical genomic testing company for psychotropics. It is ordered and reviewed by physicians but may be more expensive than whole genome sequencing.

4.3

Edited by Christina Swords, Ph.D.

7 Facts from our GeneSight Review

1. 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 with weekly updated reports (incl. mental health), data exploration tools, and advanced ancestry reporting).

GeneSight Introduction

This is a review of GeneSight, a diagnostic DNA test from Myriad Genetics. Reports focus exclusively on genes relevant to psychotropic medications. In 2016, Myriad Genetics also acquired Assurex Health, an informatics-based precision medicine company providing treatment decision support to healthcare providers with mental health patients.

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. It can save months or years of a painful trial and error process to find the right medication for conditions that are difficult to treat. 

GeneSight’s product is backed by seven peer-reviewed studies and clinical trials, including one study showed higher remission rates among those who took the 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:

• People with depression or major depressive disorder
• Anxiety disorders
• Mood disorders
• Bipolar disorder

GeneSight psychotropic DNA tests are specifically marketed as Genesight ADHD as many of the drug results are relevant to both adult and children with ADHD.

Another major difference between Genesight and other genetic sequencing sites is that the Genesight test is a clinical test. DNA samples are collected at a doctor’s office or medical center. GeneSight results are reviewed by the medical staff. Patients can follow up with a doctor to discuss the genetic information received in the results.

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

The Science behind GeneSight

The company 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. This branch of science claims that genes may affect the way some medicines work in the body. For example, codeine is often prescribed as a pain killer, but remains ineffective for about 10 percent of people (National Institutes of Health). 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 GeneSight testing cost.

However, more recently, GeneSight has published more studies. Sponsored by Assurex Health Inc., GeneSight completed a 12 Week, Randomized, Double-Blind, Controlled clinical trial in 2017.

A similar service is Genomind, that also focuses on genetic testing to help medical providers treat mental health disorders.

Review of GeneSight Testing

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 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 the company to understand the report before communicating the results to the patient.

GeneSight does offer a my GeneSight provider login portal for registered healthcare providers. Here, medical providers can use their Genesight login to access their patient reports either online or on a mobile app.

GeneSight Genetic Counseling

GeneSight’s test must be ordered by a health care 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 and guide treatment. It recommends consulting with a psychiatrist or primary care physician for professional medical advice before starting to see a GeneSight provider. 

Review of GeneSight Report Details

GeneSight provides a sample report for patients to review before purchasing their service. The official name for the Genesight psychotropic test 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.

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.

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).

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). 

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.

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 medication for depression. Understanding this information may help doctors better target and treat depression.

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.

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.

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 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. The company 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 GeneSight testing in full.
• Medicare Advantage: Typically $330 or less. The company claims to contact patients if costs will exceed $330.
• Employer/commercial providers: Typically $330 or less. The company 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, the company 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. 

The company 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

• Time Magazine article
• Bloomberg: DNA Testing for antidepressants raises questions from the FDA (Food and Drug Administration)
• Barrons: Myriad Genetics stock has an FDA issue
• NPR story about some genetic tests for drugs are now covered by insurers

GeneSight Reviews

• The Carlat Report GeneSight review. “We’d conclude that there’s very little reliable evidence that it works” based off usual standards for drug prescription
• Reddit thread discussing the benefits and risks
• Reddit thread pleased with GeneSight
• Minimal GeneSight reviews on Facebook
• Journal article reviewing GeneSight and others (by American Psychiatric Association)

GeneSight Pros and Cons

Pros

• Specifically tailored to psychiatric medication 
• Offers a diagnostic test with sign-off from doctors
• Insurance may cover the test
• 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 $0 – $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.

GeneSight vs Ancestry vs 23andMe vs Nebula Genomics

Alternative products similar to GeneSight include GenoMind, GeneCept, and CNSDose. You may also be interested in antidepressants like Lexapro and Zoloft.

If you are looking for clinical genetic testing, take a look at

• Ambry Genetics (risks of various disease types)
• Color Genomics (risks of cancer, genetic forms of heart disease, and medication responses)
• GeneDx (wide variety of clinical genomic tests)
• Genomind (pharmacogenomic testing for mental health treatment)
• Integrated Genetics (pre- and post-pregnancy tests)
• Invitae (diagnostics, proactive health, and reproductive health)
• Myriad Genetics (diagnostics, reproductive tests, and precision medicine tests)
• Parsley Health (holistic medicine and health plans)
• Pathway Genomics (DNA tests for various health aspects, may be used in consultation with medical providers)
• Veritas Genetics (disease risks and carrier screenings)

Pathway Genomics offers a clinical grade test specifically for psychiatric drugs.

Did you like our GeneSight review? You can read more reviews on our blog and check out our complete guide to the best DNA test kit and other home tests.