Response to "Stressed by His Short Allele"

My two most recent articles are closely related. Both discuss genetic variation and how certain people react to medicines differently then others. I have to pose the question is this going to put a dent in ones wallet? And are doctors as well as pharmicutical companies going to invest the time and money? "those people who have a short allele for the serotonin transporter have been suggested to exhibit more "anxious" personality traits. This means our differences in gene function may bias our brains and our personalities to create a tendency to be more "negative," "anxious" or reactive to stress." Does this only refer to mental health or are other medicines as well as the way they affect you differed by your genetic makeup?

Stressed By His Short Allele

Individual differences in the genetic makeup of the serotonin system have been shown to increase one's vulnerability to depression, anxiety and other psychiatric conditions, particularly if individuals are exposed to stressful events in their lives. Studies are showing that certain people (those that have the short allele of the serotonin transporter gene) have a greater biological reactivity to stressful events, including a larger hormonal response to stress and a greater brain reactivity to threat. In other words, both the hormonal and brain systems (amygdala) involved in fear and anxiety are more active in response to stress in those individuals who have a certain genetic makeup (short allele). This genetic difference may also account for individual differences in personality; those people who have a short allele for the serotonin transporter have been suggested to exhibit more "anxious" personality traits. This means our differences in gene function may bias our brains and our personalities to create a tendency to be more "negative," "anxious" or reactive to stress.

This begs the question: should modern medicine and psychotherapeutic approaches be extended to better account for these individual genetic variations in the stress response (and the serotonin system)? The idea that we may be able to refine our approach to medicine to account for these types of individual differences (in genetics, personality, the stress response and beyond) is pertinent to the continuing evolution of medicine and science, and one that is indeed increasingly being adopted by clinicians interested in a "personalized medicine" approach to traditional medical treatment and other forms of therapy. Furthermore, looking at a person's biological make-up has applications for being able to better predict which individuals may be more at risk for mental health difficulties.

While the idea that our genetics may be used to tailor our individual medical treatments and to screen us for vulnerabilities could appear to some like a vision from the movie Gattaca (1997 science fiction film), such refinement in our medical approach may prove to be a significant step forward.

Response to Dr. Francis Lee

I had no idea that there was such thing as "pharmacogenetics" which uses your genes and other genetic information to test how you'll react to medications along with classes of medications. But is this going to cost an astronomical amount of money? most likely but instead of all the trial and error shouldn't it be made available. The use of pharmacogenetic testing is viewed by many as an outstanding opportunity to improve prescribing safety and efficacy. Driving this are the 106,000 deaths and 2.2 Million serious events caused by adverse drug reactions in the US each year.

Dr. Francis Lee (Developing Genetic Test To Guide The Treatment Of Depression)

Dr. Lee's researchs into the molecular and neural mechanisms of depression, anxiety disorder and other mental illnesses. In particular, he identified that a genetic variation, or SNP (single nucleotide polymorphism), in the gene for a growth called brain-derived neurotrophic factor (BDNF) may predict patients' responses to drug treatment. This new approach, known as pharmacogenetics, could lead to diagnostic testing to guide the treatment of depression, replacing the current "trial-and-error" method. Dr. Lee's research with mice show that those with the BDNF polymorphism are more prone to anxiety and respond less successfully to a class of common antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine, citalopram, paroxetine, and sertraline.

Dr. Lee is using this research toward treatment of survivors of the 9/11 terrorist attack and veterans of the Iraq and Afghanistan wars that suffer from post-traumatic stress disorder. Working with his NewYork-Presbyterian/Weill Cornell colleague Dr. JoAnn Difede, Dr. Lee screens patients for the BDNF polymorphism. They hypothesize that patients with the polymorphism may not respond the same to SSRIs, but may respond better to different treatment approaches (that do not rely on BDNF function) such as cognitive enhancers like D-cycloserine (DCS) combined with Dr. Difede's virtual-reality exposure therapy. According to Dr. Lee, approximately 30 percent of patients test positive for the BDNF polymorphism.

Response to Antidepressants may damage more sex lives

Not that I can relate to this topic or even being to understand how it effects a persons sex life, but I found this rather interesting. Of course there are pro's and con's to everything but would you think that part of your life would change so dramatically from taking a medication that is supposed to be helping you. After reading this article and doing a little bit more research it showed that some people never stop having these side effect while others once off the medication are perfectly fine. "In the past two or three years, scattered published case reports from around the country have described patients whose sexual symptoms failed to resolve after going off antidepressants". I'm surprised these side effects aren't printed on the bottle. Like in my previous posts pharmaceutical companies fail to warn doctors as well as the patients of possible side effects. Psychologist Audrey Bahrick at the University of Iowa says "Among their symptoms, were "telltale signs" of SSRI-caused dysfunction, unrelated to the known effects of mental illness. They had "pleasureless orgasms," and "genital anesthesia," in which sex feels no more intense than a handshake. She became particularly concerned about adolescents put on antidepressants, whose sexuality might never have a chance to develop normally". With 74.5 % of teens on antidepressants that's a large amount of people it could possibly affect. This article also says this mean about 1 in 8 american adults are affected by SSR's. Kenvin Bennett, a 30 year old whos sexual functions was perfectly fine until he turned 18 and was prescibed Prozac. He has been impotent ever since. His doctors as well as others cant seem to find an alternative explantion other then SSRI.

Response to Dr. Francis Lee

I had no idea that there was such thing as "pharmacogenetics" which uses your genes and other genetic information to test how you'll react to medications along with classes of medications. But is this going to cost an astronomical amount of money? most likely but instead of all the trial and error shouldn't it be made available. Pharmacogenetic testing is viewed by many as an outstanding opportunity to improve prescribing safety and efficacy. Pushing this are the 106,000 deaths and 2.2 Million serious events caused by adverse drug reactions in the US each year. I would like to know more about what exact polymorphism it is that causes the anxiety and stress in comparison to the ones that don't