We are all affected by the coronavirus in one way or another. As we adjust to our current reality, which can feel so different from life before this pandemic, concerns about mental health are increasing. The anxiety and sadness that many are experiencing is real. It may stem from many places such as worry for the health of yourself or a loved one, prolonged social isolation, the loss of employment, the increase in demands of employment, or life plans that need to be postponed. And healthcare workers continue to be overwhelmed by their work on the front lines.
The Kaiser Family Foundation has been conducting frequent polls about the effects of COVID-19. The percentage of people reporting a negative impact on their mental health has increased from 32% in early March to 45% in late March. The most recent poll (April 15-20) showed that 56% of respondents reported that “worry or stress related to the coronavirus outbreak has caused them to experience adverse effects on their mental health or wellbeing” over the prior two months, with higher percentages in households with a healthcare worker or where one or more person has lost employment.
These mental health effects can have detrimental impacts. The Meadows Mental Health Policy Institute developed models for the current crisis looking at how death by suicide can be tied to economic recession and increased unemployment. And a recent article in Scientific American examined how the psychosocial impacts of the pandemic could lead to an increase in suicides.
Pharmacogenomics and mental health treatment
While I have been struck by how the world community is pulling together to help one another during this time of uncertainty, there’s no doubt that COVID-19 is causing an emotional health crisis. Many of my colleagues are seeing a spike in patients suffering from anxiety, depression and OCD, precipitating greater need for therapies like antidepressants and anti-anxiety medications.
A recent study found that initial antidepressant drug therapy fails for between 30% and 50% of patients due to ineffectiveness or intolerance. This leads to a trial and error method of prescribing with dose adjustments, switches in medication, further dose adjustments, and so on before a patient’s depression is controlled. During the current pandemic and mental health crisis, this trial and error method can also lead to increased risk of exposure to COVID-19 through ongoing in-person appointments.
Pharmacogenomic (PGx) testing can give providers a valuable tool to help them determine how a patient may respond to certain medications, including many used to treat mental health conditions. The genetic information providers receive may help them optimize medication selection for their patients, reduce medication trial and error, and minimize the risk of adverse reactions.
Decreasing the number of dosage adjustments or medication changes for a patient can also free providers’ time to help more patients and limit physical interaction in practices that don’t offer telemedicine visits. It may also help reduce unnecessary suffering in patients whose mental health has been affected by the COVID-19 pandemic.
Beyond the pandemic
The benefits of PGx testing go beyond mental health treatment. A broad panel PGx test can provide insights into how patients may respond to many medications used to treat conditions like cancer, pain, and more.
COVID-19’s effects on our world are significant. And as we work to adjust to our new normal in healthcare, many things will be different - from the broader adoption of telemedicine to new precautions against future outbreaks of this magnitude. One thing that I hope the healthcare community embraces is the value of precision medicine, including pharmacogenomic testing, when treating patients.