Senior seminar summary #5

Riya Shah

Senior Seminar

Dr. Ko

October 27, 2022

Summary

This week’s presentation was given by Rachel A. Montel, PhD, a Medical Science Liaison at

Myriad Genetics. Her presentation was titled “Using Pharmacogenomics to inform Depression

Treatment”. When taking a closer look at depression as a disorder, it is very difficult to achieve remission.

She spoke about two important categories of genes: Pharmacogenomics and Pharmacokinetics.

Pharmacogenomics refers to how information is provided on how DNA may impact the response to

certain medications and Pharmacokinetics provides information on the metabolism of medications.

These genes show variations in changes on how the drug affects the body and how the body affects the

drug.

GeneSight reports show which medicines may be less likely to work, which may require dose

adjustments, or may have increased risk of side effects based on the patient’s genetic make-up. Clinical

considerations state the rationale for a medication’s classification and offer treatment adjustments if a

clinician decides to use that particular medication. One particular type of medication is mood stabilizers.

Medications in this category do not have clinically proven genetic markers that allow them to be

categorized. However, they may still prove to be effective based on other clinical factors.

Another important topic she covered was how genetics can affect medication blood levels. There

are four types of metabolizers: Poor, Intermediate, Extensive (Normal), and Ultrarapid. Poor metabolizers

break down medications very slowly. They may experience side effects at normal doses. Intermediate

metabolizers break down medications slowly. They may have too much medication at normal doses.

Extensive or normal metabolizers break down medications normally. They have normal amounts of

medication at normal doses. Ultrarapid metabolizers break down medications rapidly. They may not get

enough medication at normal doses.

She covered the importance of choosing patients for GeneSight testing. There are no clear

clinical guidelines to identify good candidates for psychiatric pharmacogenomic testing as of yet. Good

patients for this testing would be patients who have failed one or more medications, elderly patients and

patients with liver damage, and patients who are very sensitive to medications. In conclusion, this was a

very interesting presentation and I believe it is a topic which needs to be discussed more often as it is

very important. Many people are unable to deal with their depression and that has negative effects on

their lives. I appreciate Ms. Montel for coming to talk to us about this.

Senior Biology Seminar (BIOL 4197)