"During a traumatic divorce Ronni Shapiro of Westhampton Beach N.Y. became severely depressed and suicidal. Psychiatrists put her on different antidepressants that only aggravated her situation. Within three months I was on  different medications Shapiro  said. It was horrible. Eventually she learned about GeneSight a new type of genetic testing by Myriad Genetics meant to help avoid the painful trialanderror process many depression patients endure in the search for the right medicine. After a simple cheek swab her results showed that pretty much everything she had previously tried was in the significant gene interaction category meaning that based on her genetic makeup these medicines would adversely affect her or prove ineffective at normal doses. Guided by her results her doctor thought that Wellbutrin would be a more promising option. And though the test is better at saying what wont work than what will her doctors decision proved the right one. I cant tell you that I am footloose and fancyfree Shapiro said. I still suffer. But when I fall into those dark holes theres like a ladder that I can see to climb up as opposed to feeling helpless. As many as twothirds of people with depression arent helped by the first antidepressant they try leaving many to spend months after they are diagnosed without real help.  READ MORE In despair from major depression I turned to a last resort Magnets http In May Myriad Genetics released the first largescale test httpsgenesight.comlandmarkstudyshowsgenesighttestledtosignificantimprovementinmentalhealthoutcomesforpatientswithmajordepressivedisorder of whether treatment guided by genetics pharmacogenomics would improve overall outcomes for patients with major depression. The study found that patients were  percent more likely to respond to treatment when their medication selection was guided by the companys GeneSight test. The test uses a proprietary algorithm to analyze  different genes to weigh their combined influence on patient response to more than  psychotropic drugs. The patients colorcoded report would read Use as directed in green moderate genedrug interaction in yellow and significant gene interaction in red. Now another company Genomind in King of Prussia is offering free education http about its genetic test Genecept Assay at SavOn pharmacies in two Philadelphiaarea Acme Markets. Specially trained pharmacists may decide to counsel patients about the Genecept test if they see a pattern of unsuccessful treatment with medicine for depression anxiety andor obsessivecompulsive disorder. No magic solution But while genetic testing offers tools to better guide patients treatment it cannot tell doctors exactly which medicines will work  or necessarily provide the key to enduring remission from depression. Vincent Sparks of Mullica Hill has benefited from genetic testing but his mental health issues have persisted. Having battled anxiety and depression most of his life Sparks  was happy to find a genetic test to help his psychiatrist better direct his treatment. After taking the Genecept test he discovered that a combination of Prozac and Lamictal was a better genetic fit for him than previous medications. But Sparks continues to struggle. I have times where Im fairly level for a while but at times it seems like Im on a roller coaster Sparks said. Sometimes I wish I could just take out my brain and wash it. If I could just put it through the rinse cycle things would be better. Though imperfect the Genecept test has been shown in peerreviewed published studies httpsgenomind.comclinicalevidence to improve patient outcomes and reduce overall medical costs. In medicine in general this will be standard of care at some point said Dan Dowd Genomind vice president. Twenty years from now everyone will have some kind of pharmacological genetic test as part of their health record. GeneSights test is covered by Medicare for patients under the care of psychiatrists and who have failed to achieve satisfactory results with at least one antidepressant. The company has coverage with some commercial payers and is working to widen that coverage said Myriad Genetics spokesman Ron Rogers. The Genomind Genecept Assay is partly covered by Medicare and Medicaid. If the outofpocket cost for people with commercial plans is more than  Genomind will contact the client before processing the test. The company also has a financial assistance program for uninsured patients. This is the beginning of personalized precision treatment said John Greden of the University of Michigan primary investigator of the GeneSight study. Onesize treatment will never fit all and were finally getting the tools not just to say that but to act on it. Knowledge is a good thing Michael Thase a psychiatry professor at the University of Pennsylvanias Perelman School of Medicine and director of Penns Mood and Anxiety program was another author of the GeneSight study. He stressed that although the test does not tell you exactly what will work it can indicate a host of medications that will be ineffective. I think knowledge is a good thing and having knowledge in improving the care of your patient is a good thing Thase said. john OReardon a Voorhees psychiatrist who treats patients with treatmentresistant depression and employs a form of neuromodulation called transcranial magnetic stimulation http TMS said that based on the results of the GeneSight study he may start using this genetic test in his practice. The absolute numbers for response  percent and remission . percent dont seem that high but unfortunately that is what you get with increasing treatment resistance OReardon said about the GeneSight study. He was more impressed with the results patients experienced a half year out. By six months the response rate was up to  percent and the remission rate was about  percent which are excellent results he said. For Marina Goldman a Jenkintown psychiatrist in private practice the GeneSight study was interesting but really beside the point. Generally she thinks that TMS and electroconvulsive therapy ECT with their high success rates  approximately  percent to  percent https for ECT and approximately  percent httpspsychnews.psychiatryonline.orgdoifull.appi.pn..ppb for TMS  offer more effective solutions for patients who have failed to respond to three or more antidepressants. At the same time Goldman presents genetic testing as an option to patients with treatmentresistant depression who are wary about trying TMS or ECT. Theres a big debate right now in the psychiatric literature and what theyre writing editorials about is that were waiting too long to refer patients out for neuromodulation Goldman said. With the genetic testing the chance of getting a response is about  percent. Why not move to ECT where the chance is about  percent for treatmentresistant patients"