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Parents of children with ADHD know that finding the right medication for their kid can be a huge challenge. But a newly available cheek-swab test, now offered at 3,500 pharmacies nationwide, is aiming to help moms and dads zero in on the most hopeful place to start.
“It’s not a panacea but it is a level of insight into how your body works with drugs to get the results they were approved for in the first place,” explains Bob Bean, CEO of Harmonyx, the company that’s just added ADHD drugs to those it can look at through the lens of pharmacogenetic — or “personalized medicine” testing. “A lot of things go into what makes a medication effective, much of which is unknown by science. But this is one more brick in the wall of understanding the effectiveness of a drug.”
Pharmacogenetic testing — which basically looks at a person’s genetic makeup to narrow down which prescriptions are most effective for that individual — is not exactly new. The possibility was identified in the 1950s although it’s far from being mainstream. That, Bean explains, has been largely due to high costs combined with varying insurance-coverage policies. But the new ADHD-drug test by Harmonyx — which also offers tests for medications including statins and Plavix — is available through pharmacies, with a doctor’s prescription, for just $89 ($99 with overnight shipping). Because state laboratory laws vary, it’s in just 14 states at this point. The results show the drugs in order of preference for each person tested, based mainly on which ones his or her body can best metabolize.
“Most parents use a watch, wait, and hope strategy,” Bean says. “This test is offering an affordable, rapid, personalized approach… and a lot better chance of getting it solved.” It wouldn’t provide a guarantee of effectiveness. But, Bean notes, when it comes specifically to ADHD medications, landing on the best one can be difficult, because the response parents are looking for is behavior-based.
Harmonyx’s announcement is timely, as a study released March 3 by Australian researchers estimates that ADHD now affects about 7 percent of children worldwide. But it’s not the first company to offer pharmacogentic testing for ADHD meds; others include AssureRx (which also tests for the potential effectiveness of depression or chronic-pain drugs) and in-house labs at various hospitals, such as the Duke University Health System.
The tests are also not without controversy, and have raised various ethical questions since their introduction. “I’m a huge fan of pharmacogenetic testing — its time is here,” genomics and medical-ethics expert Dr. Carol Isaacson Barash tells Yahoo Parenting. However, explains the founder of Helix Health Advisors and editor-in-chief of the journal Applied & Translational Genomics, parents should consider all of the possible results of such testing — including what knowledge you may receive that you weren’t necessarily looking for. For example, she explains, the markers discovered in a phrarmacogenetic test may be solely focused on medications; but who’s to say that, some years down the line, that same information won’t be a marker for early onset Alzheimer’s or various cancers? In other words, she says, you could be getting more than you bargained for, for better or worse.
“It’s deeply personal,” Isaacson Barash explains, and it raises issues of consent. “You can’t really give consent, because you don’t know what’s coming down the road. Researchers can’t even explain all the ways someone’s data might be used in the future, because they don’t yet know what the data mean and how it might be useful. So parents who make decisions have to be cautious for their kid, because of the information that may be yet to come.”
Another thing to consider, she suggests, is privacy, and the idea of one’s sensitive genetic information being out in the world. To feel safe about this aspect — as well as the basic accuracy of tests you’re considering — she suggests being a good consumer and doing plenty of research. Check to Federal Trade Commission website to see if the testing company has ever received cease and desist notices, search PubMed for relevant studies on tests and companies, find out if the company uses what’s known as a CLIA-certified lab (Harmonyx does), and always discuss such a decision with your child’s doctor first. “It’s buyer beware,” she says. “You don’t want to get the wrong result.”