Genetic Test Aims to Take Guesswork Out of Drug Dosing

Dec 18, 2013

Gualberto Ruano, director of the Genetics Research Center at Hartford Hospital, leads a study aimed at reducing the guesswork in psychiatric drug dosing.
Credit Chion Wolf / WNPR

Researchers at Hartford Hospital are looking into a gene that determines how fast the liver clears medication from the body. The goal of the five-year study is to reduce the guesswork in psychiatric drug dosing.

It's a gene with a fancy name: CYP2D6

"CYP2D6 is part of a family of 50 or so genes that detoxify substances," said Gualberto Ruano, director of the Genetics Research Center at Hartford Hospital. He said the gene is especially relevant for the field of psychiatric medicine because it produces enzymes in the liver responsible for clearing some depression medications from the body.

But here's the rub: people express this enzyme-producing gene differently. This means doctors aren't always giving patients the right doses of medication for things like depression. "If a drug requires that enzyme [in order] to be broken down, and the patient does not have it, the drug will build up and create side effects," Ruano said. "If the patient has the enzyme in a super-active form, that drug will be broken down quickly and have no effect."

Earlier this month, the Agency for Healthcare Research and Quality awarded Hartford Hospital a $1.25 million grant to study the impact that genetic testing could have in better targeting drug prescriptions. Ruano says the pharmacology and the genetics behind these types of tests are "rock solid." "What is being investigated in this study is the effectiveness of this kind of testing in a health care environment, particularly in a hospitalization environment," Ruano said.

One outcome of this research could be to make this type of genetic assessment a part of standard care for every hospital patient prescribed psychiatric medication. Ruano said he estimates the research at Hartford Hospital will involve about 1,500 patients over the next five years. He said it's one of the largest prospective studies in the field of personalized medicine ever conducted.