How treatment for ADHD can be personalised with genetic testing
After watching your child struggle for months to sit still or maintain focus, it can be a relief to hear that your child has attention-deficit/hyperactivity disorder (ADHD).
You may have a few more hurdles to jump if your child’s clinician recommends ADHD medication. While there are many medications available that may be able to help your child, finding one that is appropriate can be a challenge.
ADHD Medication: 3 Ways Genetic Testing Can Help
It is possible to manage ADHD in a number of ways with genetic testing, specifically pharmacogenomic testing. Clinicians can use this information to more accurately determine whether certain medications are likely to work. Furthermore, it can be used to determine what dosage is best for each individual patient and help patients reach their treatment goals.
Clinicians Can Use Genetic Testing to Determine Which ADHD Medications to Try
ADHD medications fall into two main classes: stimulants and non-stimulants.¹ Both are effective at treating ADHD, but they work differently, and children may not respond the same way.
Stimulants
Amphetamines and methylphenidate are included in this class.
Stimulants give dopamine and norepinephrine to your brain. Dopamine and norepinephrine are neurotransmitters, meaning they transmit signals to different areas of the brain. Specifically, dopamine is tied to attention, motivation, and movement.²
A stimulant awakens a part of the child’s brain that’s been sleeping. This activates the executive function of the brain, meaning the child is less likely to get distracted and lose focus.
Non-stimulants
Norepinephrine, on the other hand, is targeted by non-stimulants. The brain’s part responsible for staying on task, managing impulses, and solving problems is stimulated by norepinephrine, just like dopamine.³
The effects of these medications may be similar to those of stimulants, but they work differently. If your child isn’t a good candidate for a stimulant, then these medications may be a viable alternative.
The medications clonidine and guanfacine also fall into this category of non-stimulants. Because these medications modulate norepinephrine and lessen the body’s central nervous system’s stimulation, they are effective in treating hyperactivity. This can result in calming effects and an improvement in concentration.
How the Psychiatric Pharmacogenomic Test Can Help With ADHD Medication Selection
The traditional way of starting a child on ADHD medication can include cycles of trial and error. You pick one medication, and if that doesn’t work, you try another.
Using the Psychiatric Pharmacogenomic Test, clinicians can understand how a medication may work for a particular child based on their genes.
Genetic Testing Can Help Clinicians Determine How to Dose ADHD Medication
Once a clinician has chosen a medication class for ADHD medication, such as stimulant or non-stimulant, the next step is to determine the type of medication and dosage within that class.
Our Psychiatric Pharmacogenomic Test can provide information on a child’s CYP450 genes, often called metabolism genes. CYP450 genes are responsible for how medications are broken down in the body.
Poor or Intermediate Metaboliser
Your child’s body may be more likely to experience side effects if the medication is not metabolized properly.
Rapid or Ultrarapid Metaboliser
In the event that your child’s body metabolizes a medication too quickly, the child may not receive the full benefit of the prescribed dose because the medication levels may be lower. In order for a medication to work as intended (relieve symptoms), the dose may need to be increased. Alternative treatments may also be considered.
How Psychiatric Pharmacogenomic Testing Can Help With ADHD Dosage Decisions
Some stimulants (amphetamines) may be impacted by CYP450 genes.
It may be necessary to give a lower dose to some children. Others may require a higher dose or even a split dose to be effective consistently throughout the day.
It is also possible to obtain additional information about patients’ medications from pharmacogenomic testing. Sometimes patients are already taking stimulants at the highest possible doses or have combinations of stimulants. Additionally, these patients may experience a cluster of side effects that are counterproductive to treating ADHD, or their medication may not have any effect at all.
ADHD Genetic Testing Can Help Families Get the Right Treatment
Each child with ADHD will have different symptoms and treatment goals. For example, one child may need more help staying focused at school, while another may have more difficulty interacting with others.
In order to improve the quality of life for the child and the family, treatment for ADHD should address the primary symptoms the child and family define as their main goals. The Psychiatric Pharmacogenomic Test can help in evaluating different medications to help address the primary symptoms.
Precision medicine allows clinicians to better manage ADHD medications by taking into account a child’s genes, medical history, lifestyle, and other factors.
With this strategy, some clinicians see positive results in as little as three visits. That means the child and family are seeing fewer symptoms with minimal side effects.
At Myogenes our experts have spent years formulating a series of tests which offer you real insights relating to your health such as The Pharmacogenetic Test, The Psychiatric Pharmacogenetic Test, The Hereditary Cancer Test, , and The Health & Wellbeing Test.
To speak to one of our advisors today, call us on 020 837 1266 or email info@myogenes.com
Sources
- Two classes of ADHD Medication: ADHD Quick Facts: Medication in ADHD Treatment (2020)
- Effects of dopamine: How Does Dopamine Affect the Body? (2019)
- Effects of norepinephrine on ADHD brain: ADHD Neuroscience 101 (2022)