“POPULATION MEDICINE” FAILING CHILDREN WITH MENTAL ILLNESS

EXPERT: NEW APPROACH TO PRESCRIBING ANTIDEPRESENTS VITAL TO PREVENTING BAD & INNEFFECTIVE RESPONSES

With reports that the rate of youth depression and anxiety has increased 70 per cent in the past 25 years, experts hope the theme of this year’s Children’s Mental Health Week 5th - 12th February, #BeingOurselves, will highlight the many problems with a one-size-fits-all approach to treating mental illness.

Research shows that less than 1 in 5 patients with depression benefit from the first antidepressant they try and, in some cases, young people may even experience an increase in suicidal thoughts or behaviours, especially in the first few weeks after starting or when the dosage is changed.

Genetics expert, Dr Sarah Lotzof from Chase Lodge Hospital’s Code You Genetics explains: “This is because when a patient seeks help for depression, the doctor plays a primitive guessing game and must wait weeks, sometimes months, to determine whether the drug is working.”

The social and economic cost of this process drove England’s Chief Medical Officer, Dame Sally Davies, to announce drastic plans to “democratise” genomic medicine, which involves using a patient’s genetic information as part of their clinical care. Dame Sally Davies aims to make genetic testing part of NHS “normal care”, offering routine testing to patients at an earlier stage to ensure medical professionals are equipped with all the information necessary to advise on treatment.

This sort of testing is particularly beneficial for young people living with mental illness. Dr Lotzof says that testing a young person’s genes will help young people avoid the adverse reactions to certain drugs, along with the risks that come from their depression going untreated.

 “We can remove all the guesswork by testing genes to determine the appropriate medicine or combination of medicines for a young person, and the appropriate dosage. The number of young people turning up to A&E with a psychiatric condition has more than doubled since 2009, so we need to take treatment seriously – depression is the leading cause of youth suicide when left untreated.”

Dr Lotzof says many doctors today must rely on persistence to find the right medication, or combination of medications, which is key to the success of any treatment regimen. This can be a long process and is not beneficial for the patient, who may experience either no relief or increased symptoms.

She says: “The excess time and money spent trying to find the right medicine for young people experiencing mental illness is avoidable and with health services overstretched as it is, we should be adopting methods that enable us to find the medication with the highest chance of working the first time.”

“Code You Genetics offers Pharmacogenomic testing, the process of examining a person’s unique genetic structure to help determine what medication will metabolize best and in what dose. While this has been around for a while – it is more accessible now because we’ve been able to lower the price due to advances in technology.”

Dr Lotzof sees Dame Sally Davies’ genetic dream as an inevitability, she says: “It will happen – it is more a question of when we will be able to scale this testing technology and the more people who know and support it the cheaper it will get. We simply do not have the resources to continue this guess-and-check process of prescribing and people are becoming more aware that their children’s unique biology and biochemical makeup changes the way they respond to treatment. Everyone wants the best care for themselves and their loved ones, and in a world where the rate of mental illness is on a steady incline, we cannot afford to play Russian roulette with the wellness of our children.”

Chase Lodge Hospital’s Code You Genetics offers full Pharmacogenomic tests to patients. Please see more information here.