Health is fundamental and important for maintaining quality of life. But, health is personal. Finding what works for you and your unique body is important. In this blog post, we will outline different strategies one can take to optimize their own personal health journey.
The first step in optimizing your health is to define what your personal health goals are. As mentioned, the definition of health varies between individuals. Do you want to start incorporating exercise into your daily routine? Maybe you want to establish a healthy sleep schedule or you would like to adopt self-care habits.
Not sure where to start? There are a variety of health and nutrition tips based on evidence that you can start to apply to your daily life to help optimize personal health. Additionally, there are several helpful applications that can help you track and outline specific health goals. Remember that health is unique to you, start with small but achievable goals.
Ensuring you receive appropriate healthcare services is essential for optimal personal health. It can be difficult at times to speak up for ourselves but by being our own advocate we can ensure that we are receiving comprehensive care. Healthline shares some great tips on how to be your best health advocate, some of these tips include:
Furthermore, if the medications you have been prescribed are not working well for you, you might consider pharmacogenetic testing and bringing up this option with your healthcare team.
Our DNA can impact our response to medications. Ensure you’re taking the right medications for your body. Finding effective symptom relief, whether that be for your mental health, pain, or other medical symptoms, is crucial for optimal personal health.
You deserve to feel better, and the knowledge of pharmacogenetics give you will empower you to reach that better feeling. If you’re ready to take your health into your own hands and make it personal, shop our pharmacogenetic test kits today.
]]>It is to be noted that self-care habits or little changes in your lifestyle can be beneficial for anyone who wants to prioritize and maintain their mental health. Let’s take a look at some important self-care habits that you can adopt to help nourish your mental health.
An important first step in prioritizing your mental health is to take time to self-reflect. One simple way to incorporate self-reflection into your daily routine is to keep a daily diary where you can reflect upon your feelings. By developing this personal insight, you can notice what situations trigger certain emotions and how you might be able to reframe these thoughts.
Similarly, mindfulness is another great self-care habit. Mindfulness doesn’t only nourish your mental health but also makes you more present and self-aware. Mindfulness practice includes reflecting on the present moment and paying attention to your current feelings, thoughts, sensations, all while adopting an attitude of acceptance. Studies have shown that practicing mindfulness has been linked to lowering stress, improving memory and decreasing depression.
Sometimes, when we are depressed or suffering from anxiety, reaching out to a friend or loved one can be quite beneficial. Surrounding yourself with positive people can in turn help you feel more positive. Remember to make time in your schedule to spend time with your loved ones. A quick coffee date or phone call with a friend can shift your entire mood.
Exercise is not only great for your physical health but can also be a great mood booster. Studies have even shown that in some people, exercise can work as well as antidepressants. High intensity exercise releases endorphins, a chemical the body makes, and results in feelings of euphoria. However, low-intensity exercise sustained over time is even more beneficial for those struggling with their mental health. This kind of activity “spurs the release of proteins called neurotrophic or growth factors, which cause nerve cells to grow and make new connections. The improvement in brain function makes you feel better” - Dr. Miller, Health Harvard.
You can start incorporating exercise into your daily routine slowly and may be as simple as going for a walk in nature. Find an activity you enjoy such as running, yoga, weight-lifting or even rock climbing. As you start incorporating exercise into your life, you should start also noticing the mental health benefits.
By adopting some of these little lifestyle changes, you might see your mood shift. However, you may also need additional support. It’s important to recognize when it may be time to reach out to a therapist or physician for help. There is nothing wrong with needing help. Therapy and medication management works for many people who struggle with their mental health.
When it comes to medication management it is also important to recognize that not everyone responds to the same medications. This is due largely to the role of genetics in medication metabolism. Over 99% of individuals carry some genetic variants that impact their response to medications. If you are considering starting a medication to help manage your mental health symptoms, consider speaking to your physician about pharmacogenetic testing. Empower yourself to actively participate in your healthcare to ensure you get a treatment plan that is tailored just for you, so you can start feeling better.
Before delving into the topic of side effects of medications, it's important to note that without depression, we cannot talk about antidepressants. Thus, let’s quickly define what “depression” means and what is denoted by “antidepressants.”
What Is Depression?
According to the National Health Institute of Mental Health (NIMH), depression is a serious mood disorder. It's a mental state that causes severe distortion to how you feel, think, or handle daily activities, including sleeping, eating, or working.
Depression can occur in many categories, which may include:
What are antidepressants?
Quite simply, antidepressants are medications taken to relieve the symptoms of depression, anxiety disorders, social anxiety disorder, seasonal affective disorder, mild chronic depression, dysthymia, or ease the pains of other mental conditions.
Usually, antidepressants aim to correct the several chemical imbalances of neurotransmitters present in the brain. These neurotransmitters are responsible for the regular change in mood and behaviour.
Types of antidepressants
The kinds of antidepressants that are readily available to be prescribed include the following:
Serotonin and noradrenaline reuptake inhibitors (SNRIs)
These are antidepressants that are often used to treat key depressions and disorders.
Similarly, they treat obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), anxiety disorders, menopausal symptoms, chronic neuropathic pains, and fibromyalgia; but these applications are often used less commonly.
Examples of SNRIs include:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are antidepressants that are most commonly prescribed. They are also used to treat depression but have fewer side effects than others.
More often than not, what SSRIs do is block the absorption of serotonin in the brain. With this, the brain cells are suitable to better send and receive information, which, in turn, leads to a more stable mood. And they are "selective" because they affect only serotonin and no other types of neurotransmitters.
Examples of SSRIs include:
Other types of antidepressants include:
Tricyclic antidepressants (TCAs)
These antidepressants are named "tri" because these medications have three rings in their chemical structure. They are used to treat anxiety, depression, and fibromyalgia , and can also help manage chronic pain.
Examples of TCAs include:
Noradrenaline and specific serotonergic antidepressants (NASSAs)
These antidepressants treat anxiety disorders, personality disorders, and depression.
Examples of NASSAs include:
Monoamine oxidase inhibitors (MAOIs)
These antidepressants are old. They are the most commonly prescribed antidepressants typically before the introduction of SSRIs and SNRIs. MAOIs are primarily used in situations where other antidepressants have been trialled without success.
Examples of MAOIs include:
Note that there are many other classes of medications that can be used to augment antidepressant effect such as the class of medications called antipsychotics but this post will not elaborate on them.
Side Effects Of Antidepressants
Most antidepressants have associated side-effects. But the most commonly seen side effects–especially with selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) include:
While these are the most common side effects that can occur with antidepressants, many of them will dissipate as your system gets used to the medication. Note that it may take up to two weeks on average before you feel better. However, some side- effects such as sexual dysfunction and weight gain may linger.
Who Gets Side Effects?
Most people react somewhat differently to the same medications. What Mr. A gets as side effects may differ from what happens for Mr. B. While some people may not experience any side effects.. The following are possible factors that can influence your response to antidepressants:
Antidepressants and the risk of suicide
Over the years, there has been a surge in the rate at which suicidal thoughts are conceived. The Food and Drug Administration (FDA) had to request a black-box warning on antidepressants because of the high risk that these thoughts impact the behaviours of children, teens, and adults under the age of 25.
Although antidepressants have somewhat been tied to the thoughts of suicide or behaviour, “it doesn’t necessarily have a definitive link with it,” according to Andrew Coulter, a psychiatrist at the Cleveland Clinic. He added that it has been discovered that "as antidepressant prescriptions increased, the suicidal rate has drastically reduced."
Due to the notion that untreated depression could itself lead to suicide, it has been generally said by a large consensus by psychological experts that the benefits of using antidepressants outweigh the risks and side effects.
There are many ways suicidal thoughts might develop. Listed below are some of the warning signs:
While the above are common with adults, children and teens also have their ways of showing signs of suicidal ideation.. Here are some of these signs:
Should you notice any of these and think of your child or if any of your loved ones might be at the risk of harming themselves, please seek emergency support immediately.
Managing specific antidepressant side effects
While waiting out side-effects is a common approach when it comes to managing the side effects of antidepressants, this doesn’t work for many who don’t have the luxury of time or patience to wait. Thus, here are some tips that can help manage the following specific side effects:
If you are vomiting, feel nauseous, have diarrhea or constipation, talk to your doctor about considering a possible reduction in dosage of your antidepressant.
4. Dry mouth: you should avoid taking caffeinated beverages or alcohol. This will make your mouth drier than normal.
Other tips you can heed to avoid a very dry mouth include:
5. Sleep problems: when you take antidepressants, it might keep you awake. But if you realize that you are feeling exhausted, you can consult your doctor to ask if you can change the time you take your medications, for instance, from morning to night or vice versa. However, if this change doesn’t still work for your insomnia, a short course of medicine like melatonin can be administered to ensure you sleep.
Managing lesser-known antidepressant side effects
Though there are a lot of antidepressant side effects that are common. However, there are also less common side effects that might present when you take an antidepressant. These include:
Meanwhile, while trying to adjust to a new antidepressant, try to watch out for certain symptoms of hyponatremia. These may include:
Treatment of antidepressants side effects.
Although antidepressants have side effects that can cause problems for people at first, they usually improve with time. Meanwhile, it's important to keep up with the treatment as it may take several weeks before you begin to reap benefits from the medication(s).
Upon commencing treatment, you’ll be required to see a doctor or specialist and follow up with them regularly —this would be at least once or twice every two to four weeks. This will allow you to check upon the progress of your condition and determine if the treatment is working adequately.
Other treatment methods.
While the use of medication to treat depression cannot be overemphasized, other effective methods can also be put into use alone or with medication management. For instance, for a start, you can decide to opt-in for things such as:
Conclusion
The rate at which people use antidepressants has tremendously increased, especially in the last 20 years. This is because, in the 21st century, people are gradually crawling into depression and need to get treatment. However, the earlier the treatment begins, the better. So, if you or your loved ones are experiencing any of the above-listed signs and symptoms of depression, you should immediately consult your doctor. If, however, you are currently on antidepressants, know that some of them have side effects, which you can get over by following instructions from your health provider. Finally, do not ignore that pharmacogenetic testing can help ensure you are on the right medication for you based on your genetics so you can potentially avoid some side-effects.
]]>Pharmacogenetic testing determines if you carry any genetic variants that could play a role in how you metabolism, and in turn respond to medications. You are unique and your response to medication is too. Genetics plays a role in drug metabolism and this is why one medication might work well for one person, but does not or just leads to increased side effects for another.
The use of pharmacogenetic testing in mental health treatment is particularly helpful as there is well established research on drug-gene interactions for many medications prescribed in this area. In addition, it is not uncommon for those struggling with their mental health to cycle through multiple medications without relief. Pharmacogenetics helps remove the guesswork of prescribing to help you find the right medication for you based on your genetics.
Inagene Diagnostic Inc. is a Canadian company who offers pharmacogenetic testing and has a test specifically for medications prescribed in the areas of mental health and pain.
Nancy White, CEO of Inagene Diagnostics Inc., spoke recently at the Mental Health and Brain event hosted by Zoomer. You can watch the replay of the interview here to learn more about pharmacogenetic testing for mental health treatment.
]]>But what if my pain lingers?
Unfortunately, for many people pain lingers even after the cause (injury, surgery, illness) of it is gone. Pain is said to be chronic when it lasts for 3-6 months or more. Chronic pain can be especially hard to manage, and many suffer without relief.
About 25% of people with chronic pain go on to develop chronic pain syndrome. Chronic pain syndrome is when the symptoms go beyond pain and include anxiety and depression. It is known that pain and mental illness are very closely linked, with most with chronic pain also struggling with their mental health.
Symptoms of chronic pain syndrome, include:
Learn more about chronic pain syndrome here
How is chronic pain treated?
There are several possible therapies that could help those living with chronic pain and/or chronic pain syndrome. Some treatments include physical therapy, occupational therapy and taking pain medicines. Speak to your doctor if you think you are struggling with chronic pain/chronic pain syndrome who can walk you through your different options.
If you are struggling with pain, you might have already tried a variety of pain medications, but you might have not experienced relief or you did get relief but in turn have been experiencing debilitating side-effects. Did you know that your genetics could explain why you aren’t finding the right pain medication for you?
Over 98% of individuals carry some genetic variants that impact their response to medications. You are unique and your response to medication is too. At Inagene, we offer a pharmacogenetic test that will let you know if your genetic makeup is impacting your response to a variety of medications, including many that are prescribed for pain. You can refer to our medication list here:
We have a test that focuses specifically on medications used to treat pain and mental health, which is ideal for anyone struggling with chronic pain syndrome. Learn more about how this test might help you feel better, sooner.]]>For many Canadians, finding the right medication is a long, and often frustrating, process of trial and error, especially for those dealing with chronic pain and mental-health issues. Time spent searching not only reduces quality of life for patients but wastes health-care dollars and resources, and can mean the difference between remaining actively employed or going on disability.
Fortunately, pharmacogenetic testing (PGx) may help people feel better sooner.
The test uses DNA to determine how an individual will metabolize more than 200 medications, from opiates to antidepressants like SSRIs (selective serotonin reuptake inhibitors), their optimal dosage and likelihood of effectiveness and adverse reactions.
Not to be confused with DNA tests that look at ancestry, ethnicity, or genetic markers for diseases like breast cancer, PGx testing reveals which genetic variants you have inherited (with nearly 100 per cent accuracy) and what that means in terms of your likely response to different drugs, according to Toronto-based company Inagene Diagnostics Inc.
It was a route that made the difference for Susan Fisher,* a 38-year-old mother of two from Alberta, who recently returned to work after struggling to manage her depression for more than 15 years.
Over that time, she was prescribed 10 different medications at varying doses – each one with side effects, including hand tremors, insomnia and severe headaches.
“My pharmacist suggested that I take a pharmacogenetic test in hopes of narrowing down the list of antidepressants that might work for me,” she recalls.
She used an at-home test kit (Personalized Insights™ from Inagene).
Available for purchase online (from $299) or through select pharmacies, the one-time test takes just five minutes and requires only a cheek swab.
Within a couple of weeks of deciding to take the test, Fisher received a detailed online report with her personalized results.
“What jumped out right away was that most SSRI drugs won’t work for me,” she says. “I was on four different SSRIs at escalating doses. The test showed I had a gene variant that caused major problems with this type of anti-depressants. My depression is essentially treatment-resistant to them. All of a sudden, everything started to make sense.”
She shared the results with her doctor who then prescribed a medication from a different class of drugs. For the first time in two years, her depression is lifting, and she has now been able to return to work.
“I wish I had this information long ago,” she adds. “It wouldn’t have lost normal, happy years with my kids. I wouldn’t have had the stress on my marriage. With this gene profile I now have, I feel I’m no longer grasping for straws.”
More pharmacists are recommending pharmacogenetic testing to patients. “It allows patients to get on the right drug quicker and help avoid adverse drug reactions, too,” explains John Papastergiou, a community pharmacist and an assistant professor at the Leslie Dan Faculty of Pharmacy and School of Pharmacy at University of Waterloo.
Each year, an estimated 200,000 Canadians will experience severe adverse drug reactions, causing death for 10,000 to 22,000 people, according to the non-profit group Adverse Drug Reaction Canada.
According to Inagene CEO Nancy White, up to 80 per cent of these incidents are preventable because they can be linked to genetics.
“Some people tend to metabolize drugs slower than others,” says Papastergiou. “With genetic testing, we’re able to predict whether someone is more susceptible to side effects. In that case, we can reduce the dose proactively or choose an entirely different medication.”
Results can be interpreted for patients by doctors or pharmacists who can intervene accordingly. Papastergiou hopes there will be more wide-scale adoption of pharmacogenetic tests in the future.
“There is a lot of value in the tests, especially for patients with certain conditions,” he says. “They do much better than those who don’t take tests. I think we’re going to become much more mainstream.”
In June, Inagene released results of a pilot project that evaluated the real-world value of PGx testing for optimizing treatments for chronic pain and mental-health conditions. The data indicates that, if used at the beginning of treatment, PGx tests would save patients more than $3,000 in wasted medications per person and 3.3 years of trial and error. With one out of every two Canadians having or having had a mental illness by age 40, the combined savings could total as much as $57-billion on average.
PGx tests have wide-reaching applications from easing the opioid crisis to enabling older Canadians to maintain their independence. White notes that PGx tests empower patients regardless of age or condition. “[A test] gives them invaluable information for their health-care decisions and it supports physicians to do their very best for the people they treat,” explains White.
White suggests not waiting to do PGx testing until you need to take medication. “Having the results before you ever take a medication will help you in the long run,” she says. “One day we’ll look back and it will seem barbaric to have put a drug in a person’s body without first knowing whether it is likely to be safe and effective. This requires a rethink among health-care providers and physicians. To be able to find the right medication through PGx testing is a real gamechanger.”
*Name has been changed.
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The Happy Molecule Podcast Video
The conversation was continued on a Facebook Live with Kevin, Inagene Diagnostics Inc. CEO Nancy White and VP of Marketing Sigrun Watson, as well as PGx expert Dr. Michael Varenbut. Listen to the Fb Live here:
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Epilepsy medications, like any medication, can lead to a variety of side effects. Listed below are some of the possible drug and side effect combinations in common epilepsy medications:
Phenytoin (Dilantin): rash, tender/swollen gums, liver damage
Lamotrigine (Lamictal): rash, difficulty sleeping, mood changes
Lacosamide (Vimpat): dizziness, nausea, sleepiness
Carbamazepine (Tegretol): rash, low blood sodium levels, fatigue
Clobazam: drowsiness, balance issues, low mood If you are seeking more information, the Epilepsy Foundation is a great resource to refer to with detailed information on epilepsy medication side effects.
Can you avoid side effects when using epilepsy medications?
It might seem like lifelong side effects of epilepsy management is unavoidable.
Is this true? Maybe. But maybe not.
Unfortunately, current scientific advancements can’t really do much to change the fact that most individuals with epilepsy will require seizure-controlling medication for the rest of their lives. But, what we do know is that current scientific knowledge has equipped us with tools to eliminate the price of admission (read: side effects) to living a normal life in most cases.
Okay, fine. It’s just one tool. But it’s compelling, and it involves harnessing your DNA to predict response and tolerance to medications. It’s called pharmacogenetics. Maybe you’ve heard of it here. Maybe you’ve heard of it elsewhere. Maybe you haven’t heard of it at all.
How can pharmacogenetics help lessen side effects of epilepsy medications? Pharmacogenetics, although a powerful tool in healthcare, is actually a quite simple process.
It boils down to is this:
A sample is taken (usually through a swab of the cheek).
It’s sent to a lab.
Magic happens.
(Ok fine – the sample is put through a mass spectrometer then talented scientists analyze the results. But it’s still pretty much magic.)
Finally, a report is generated and sent to you and/or your pharmacist and/or your doctor. It tells you what medications your healthcare provider might want to avoid. Maybe you’re susceptible to weird tingling sensations (i.e., “paresthesias”) or headaches or mood swings with topiramate (Topamax). The report insights can help guide your treatment plan and hopefully help you feel better, sooner. You are unique and your response to medication is too. A pharmacogenetics test will help ensure you are prescribed medications that are predicted to work best for you based on your DNA.
How can I get a pharmacogenetics test?
Unfortunately, pharmacogenetics isn’t mainstream. Yet. Healthcare providers in general are currently playing catch up with the science, but that doesn’t mean it’s not yet accessible to you and your healthcare team right now, and fortunately, it’s pretty easy for them to learn, interpret and implement into their respective practices.
Abracadabra! The future is here. You can order an Inagene Pharmacogenetics Test Today. To see if a medication you are currently taking is on our report, refer to our medication list.
Unlock the powerful insights of pharmacogenetics today.
]]>The risk may be further amplified by the current “echo COVID-19 pandemic" of mental health issues, as depression and anxiety significantly increase the risk of developing chronic pain after surgery. Unfortunately, when chronic pain is not adequately managed there is an increased risk of building a drug tolerance to pain medications or dependencies to opioids. However, genetic testing known as pharmacogenetics can help mitigate the risk of chronic pain and reliance on medications.
Can pharmacogenetics help manage postoperative pain safely and effectively?
Advancements in genetic testing, termed pharmacogenetics (PGx), gives insight into which pain drugs will be most compatible with a person’s DNA. When completed ahead of surgeries, patients and physicians can use this information to inform anesthesia and postoperative care, enabling better pain control and improving safety by reducing the risk of adverse drug events.
“PGx testing can be a useful tool in ensuring the hundreds of thousands of patients about to have surgery will have their postoperative pain safely and effectively managed, helping limit their risk for developing chronic pain and minimizing their exposure to opioids,” said Dr. Lydia Hatcher, Associate Clinical Professor of Family Medicine at McMaster University, with a focused practice in chronic pain.
Inagene Diagnostics offers a PGx test with over 140 medications used to treat mental health and pain (link to product page). The test kit retails at $299 CAD and can be ordered online without a physician’s referral. Results can then be easily shared with your physician to help ensure you are prescribed the right medication for you based on your DNA.
Learn more how pharmacogenetics can help with chronic pain post-surgery here.
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Matching individuals with effective treatment to manage their pain is often a challenging and lengthy process, due to wide variations in responses to pain drugs between individuals. However, advancements in genetic testing and personalized medicine, termed pharmacogenetics (PGx), may play a significant role in helping realize this goal.
How can pharmacogenetics help find effective pain medications?
Pharmacogenetic testing provides highly personalized insights on which medications and doses would be most effective with the least side effects for each individual, based on compatibility with their DNA. PGx testing offers an alternative to the “trial and error” method, providing healthcare providers with a personalized “roadmap” to treatment success, while empowering individuals to take an active role in their own treatment.
A recent pilot study of 50 chronic pain patients illustrated that, on average, individuals living with chronic pain could save over three years in frustrating drug ‘trial and error’ and over $3,000 in wasted drug costs just by taking a PGx test at the beginning of their treatment journey. Pilot Study overview.
How can I order a pharmacogenetics test for pain?
At Inagene Diagnostics we offer a test specially for those struggling to find an effective medication(s) to manage their pain and/or mental health.Chronic pain and depression are often closely linked with 50% of those with chronic pain reporting feelings of depression, while 35% report suicidal ideation. Our Pain and Mental Health Test provides insights on over 140 medications used to treat these conditions.
Find out which medication is predicted to work best for you based on your DNA and start feeling better sooner. Read more about the utility of PGx testing for chronic pain management here.
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How can a pharmacogenetic test help someone struggling to manage their depression?
Pharmacogenetic testing has helped many Canadians feel better, sooner. For example, Susan Fisher*, a 38-year old mother from Alberta had struggled to manage her depression for more than 15 years. She had been prescribed 10 different medications, each one with side-effects, including hand tremors, insomnia, and severe headaches.
This is not an uncommon experience for many who are trialing different antidepressants.
Her pharmacist suggested she take a pharmacogenetics test to help find out which antidepressant is most likely to work for her based on her genetics. She ordered an Inagene pharmacogenetics test kit (link to shop page) and received a detailed report with valuable insights a few weeks later.
The test showed she had a gene variant that caused her to react negatively to SSRIs, which are typically prescribed for depression. Her depression was thus treatment-resistant to SSRIs. Sharing these insightful results with her doctor allowed her to get switched to a new class of drugs and for the first time in two years, her depression lifted and she was able to return to work.
Is pharmacogenetics becoming common-practice in Canada?
Pharmacogenetics is slowly being incorporated into the Canadian healthcare system. More pharmacists are starting to recommend pharmacogenetic testing to patients. However, you do not need a pharmacist’s or physician's referral to order a test. Learn more about the power of pharmacogenetics here.
Read more about Susan’s story and our full feature in The Globe and Mail here:
*Name has been changed
]]>This partnership is helping us bring the best of locally manufactured medical products to Canadians. Our pharmacogenetics test is conducted using an oral cheek swab (explore the process) that analyzes a person’s DNA to determine which medication is predicted to work best for them. Granville Biomedical Inc., who specializes in the design of medical devices, is thus developing a specially-designed buccal swab for our test kits launching in 2022.
The addition of these swabs will help ensure that we continue to support the Canada supply-chain and bring the best quality product to our customers. Learn more about this partnership (read the full press release) and Granville Biomedical (link to website).
]]>The negative effects of ineffective treatment for pain and mental illness can be tremendous, with 64% of patients enrolled in this study revealing they had missed work because of sub-optimal treatment or medication side effects.
The study’s objective was to evaluate if PGx testing could help reduce the burden of time and cost involved in trialing different medications and doses for this patient population.
The results revealed that having access to the Inagene PGx test results sooner would have improved the treatment experience for 100% of these patients.
Read more about the pilot study here.
Read more about our partnership with Calian Health here.
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“Richard” is one of the six million Canadians with a story to tell about living with chronic pain and the impact on his mental health. A workplace accident 14 years ago led to a long and difficult journey that has completely altered his life since. But thanks to his participation in a recent pilot study involving pharmacogenetic testing, his journey has taken a promising turn.
Richard is a husband and father who has lived with chronic pain for over 14 years, resulting from a workplace accident where he fell over 40 feet on a construction site in 2007. Severe injuries to his left and right shoulders required several surgeries to repair. He is also tormented by painful diabetic neuropathy of his hands and feet. Daily pain has severely impaired his ability to sleep, concentrate, or work, forcing him to go on long term disability, and to retreat from activities and social events he used to enjoy. As often the case for those living with unrelenting pain, he also developed clinical depression and anxiety.
Did you know?
At least one in two Canadians will be diagnosed with a pain condition, a mental health condition, or both in their lifetime. Pain and mental health are closely (genetically) linked, and a diagnosis of one increases the risk of developing the other by up to three-fold. When mental health-related symptoms flare up or are sub-optimally managed, pain typically becomes worse, and the reverse is also true. |
Richards doctors have prescribed a myriad of medications for his pain and mental health issues over the years that either seemed to provide little to no effect, and/or resulted in side effects ranging from feeling even worse physically, to terrible nightmares and even suicidal ideation. His persistent symptoms, coupled with the side effects, have had a profound impact on Richard’s quality of life, in addition to his ability to work.
Did you know?
The traditional “trial and error” method to find effective treatment of pain and mental health conditions results in treatment failure for up to two-thirds of patients, leaving most cycling through multiple drugs and doses seeking relief. Studies have shown that chances of recovery decrease while chances of side effects increase with each new drug trial. Ongoing symptoms over several weeks can lead to these conditions becoming entrenched (“chronic”), and a progressive “downward spiral” of worsening pain, depression, anxiety, and sleeplessness that is ever-more difficult to recover from. Chronic pain is associated with the worst quality of life of any chronic disease, and chronic pain and mental health issues are the top two drivers of disability and health-care system costs in Canada. |
After cycling through multiple drugs and doses for over 14 years, Richard was still struggling with persistent symptoms when his doctor suggested that he participate in a new pilot study investigating whether a new innovative DNA test (Inagene Personalized Insights™ pharmacogenetic test) could help those with chronic pain find more effective treatment sooner. His physician explained that the study involved taking a one-time cheek swab test, and that a few days later the test results would reveal which drugs and doses would work best with the lowest likelihood of side effects, based on Richard’s genetic profile. Richard decided to participate and take the test in the hopes that it might help him find treatment success, or that it might give him some explanation for why nothing seemed to work well for him without side effects.
The Pilot Study:
In 2020-21, Inagene launched a ground-breaking “proof of concept” pilot study supported by Calian Group. 50 Canadian patients who were being treated for chronic pain and concurrent mental health conditions were recruited from a busy Primacy* clinic for the pilot study in late 2020 to evaluate the “real life” impact PGx testing could have on treatment, and on the time and cost burden involved in trialing different medications for people with chronic pain and/or mental health conditions. |
The results of the test explained a lot. The test report revealed that at least twelve of the drugs Richard had previously trialled and later discontinued were incompatible with his genetic profile. Looking back, Richard recalled that all of these drugs had either provided little effect and/or were intolerable, resulting in them eventually being discontinued weeks or months later. He and his doctor agreed that, had the test results been available years ago (before starting treatment), many of these medications would likely have been avoided altogether, potentially saving thousands of dollars in wasted drug costs, and (more importantly) many years cycling through drugs that were genetically destined to fail.
At the time of testing, Richard was still taking one medication that the test flagged as a ”Use With Caution” drug for him, based on an increased likelihood of side effects. Not surprisingly, Richard’s doctor had been unable to increase this drug to a dose that provided relief without it becoming intolerable. They decided to replace the drug with another that was more compatible with Richard’s DNA. One month into taking the new medication at the low starting dose recommended by the Inagene report, Richard returned to his doctor to report that his neuropathic pain was almost completely resolved, and that he felt a significant reduction in his shoulder pain. He wasn’t experiencing any side effects with his new treatment, and based on his improved symptoms, his doctor was even able to decrease his overall dose of opioids.
Richard was extremely grateful for having decided to participate in the study and take the test: “I cannot put into words how valuable this is to me. To wake up in the morning and my hands and feet aren’t on fire or screaming at me, to look forward to working again, to be able to do stuff with my kids....I would pay all the money I have for this chance at life again.”
Richard’s experience with the pilot study was not atypical:
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Read more about the pilot study here.
]]>During the fireside chat, Jane and Nancy explore post-pandemic trends pertaining to healthcare at a global scale. They discuss what is shaping the future of healthcare as we steer away from a fragmented approach to care.
Some learnings from Episode 5 include:
Visit Jane’s healthcare blog: https://www.healthpopuli.com/
Watch Episode 5 on Youtube or listen to the audio through Spotify!
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“Canadians suffering from mental health conditions stand to save over $57 billion dollars with use of pharmacogenetic testing; Pharmacogenetic testing can help patients avoid years-long ‘trial and error’ phase of a treatment plan, transforming the experience of Canadians living with physical or psychological pain.”
It can be argued that, if innovation is needed anywhere in our healthcare system and in employee health plans, it is in the areas of mental health and chronic pain. These conditions impact quality of life more than any other conditions3, and are the leading drivers of substance abuse issues4, suicides5,6,7 absenteeism, disability, and overall healthcare system costs 8, 9
At least one in two Canadians will suffer from mental health or chronic pain condition (or both) in their lifetime 1, 2. The COVID pandemic has greatly exacerbated these issues, with record levels of depression, anxiety, and substance abuse, coupled with difficulty accessing relief via interventional treatments and procedures, and medical or psychological support.
Pain and mental health are closely (genetically) linked, and a diagnosis of one greatly increases the risk of developing the other. When mental health-related symptoms flare up, so typically does pain, and the reverse is also true. Those with chronic pain are twice as likely to commit suicide compared with people without chronic pain. In fact, one of the most effective mechanisms of reducing physical pain is to effectively address any concomitant psychological pain (depression or anxiety), and vice versa. Even the drugs used to treat these conditions overlap to a large extent.
Those with uncontrolled pain conditions are 3 X more likely to develop depression or anxiety, and those with uncontrolled mental health conditions are 3 X more likely to develop chronic pain. |
While 70% of people with pain or mental health conditions take medications, and nearly a quarter take 3 or more 10, treatment of these conditions is notoriously difficult due to large variations in responses to medications. Drugs and doses that work well for one person are often completely ineffective or cause significant side effects in another.
For years, physicians have had to rely on medication “trial and error” to find something that works for each patient, resulting in up to two-thirds of patients failing the first drug treatment tried, and enduring weeks, months or even years of frustration and expense cycling through multiple drugs and doses.11 - 16
Some populations are at particular risk for BOTH chronic pain and mental health issues, including front line healthcare workers and emergency services, and those who’s work is physical or emotionally stressful in nature (ex. police services, corrections, armed forces personnel.) Women and indigenous populations are also at enhanced risk.
The pandemic has further enhanced relative risk and burden for these populations since early 2020.
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Reliance on the traditional “trial and error” method (and the time and frustration involved in this process) often has dire consequences, as time is of absolute essence in treating both pain and mental health conditions. Chances of recovery decrease with each new drug trial, and ongoing symptoms can quickly lead to a progressive “downward spiral” of worsening pain, depression, anxiety, and sleeplessness that is increasingly difficult to recover from, ultimately leading to withdrawal from activities, multiple medications being added on with overlapping side effects, and increasing absences and disability17, 18. Further complicating matters, drug tolerance, which can reduce drug effectiveness further, can rapidly develop, as can drug dependence, with accompanying withdrawal syndromes, potential for abuse, and risk of overdoses.19
In term of promising innovations to improve the odds, drug development in pain and mental health has yielded few new options in the last two decades, with few new drugs on the horizon, meaning that if we are to improve these stats, we must find ways to do better with the treatment options we already have. Enter pharmacogenetic testing or “PGx”.
An alternative to “trial and error”, PGx tests predict which medications and doses are likely to work best for an individual, and which to avoid, based on their DNA.
PGx testing is a simple cheek swab test that can significantly reduce the time and complication needed in finding effective and tolerable treatment for pain and mental health conditions. Inagene Diagnostics Inc. is a Canadian healthcare company dedicated exclusively to bringing personalized medicine to Canadians suffering from chronic pain and mental health conditions. Inagene produces a unique PGx test focused exclusively in Pain and mental health, testing for more genes, variants, and drugs involved in these conditions than any other provider. |
Guiding treatment based on PGx test results has been shown to produce impressive results, with some studies in mental health showing quadruple symptom improvement, double response rates, and nearly double remission rates when treatment is guided with pharmacogenetic testing insights. 20, 21, 22 Studies using PGx test results to guide treatment in pain have shown significantly improved pain scores23, 24, 25, a well as significantly reduced utilization of opioids 24, 25. Other studies have shown emergency room visits and hospital admissions can be reduced by 30 - 40% 26 – 27
Not surprisingly, these clinical improvements drive significant cost savings. Studies have shown savings of $1,000 - $4,000 CAD per year per person in drug costs can also be achieved when using PGx to guide treatment.28 – 31
As the pandemic was continuing to drive epidemic levels of mental health and pain issues across Canada at the end of 2020, Inagene joined forces with one of Canada's largest national health services organizations Calian Health, to explore the real-world impact of pharmacogenetic testing as an innovation with potential to significantly improve the journey and outcomes of Canadians living with pain or mental health issues.
Calian Health is combining innovation with decades of experience in the management of healthcare professionals, primary care and occupational health clinics, pharmaceutical research and Patient Support Programs. Calian is a major employer of front- line health care workers, serving more populations at particular risk for both pain conditions and mental health issues than any other Canadian contract healthcare services company. *Primacy, a Calian Company, is the largest medical property management provider in Canada, with over 150 clinics offering a wide range of medical services to over 6 million Canadians annually.) |
Calian Group Ltd. is one of Canada's largest national health services organizations, and provides contract healthcare services to many of the populations carrying the most significant burden of pain and mental health concerns, including emergency services workers, police and correctional services, and the armed forces.
In 2020-21, Calian supported a ground-breaking “proof of concept” pilot study by Inagene Diagnostics to evaluate the “real-life” value of PGx testing in optimizing treatment of chronic pain and mental health conditions. 50 Canadian patients who were being treated for chronic pain and concurrent mental health conditions were recruited from a busy Primacy* clinic in PEI for the pilot study in late 2020. The Pilot Study Objective: evaluate the impact PGx testing could have on treatment, and on the time and cost burden involved in trialing different medications.
The results of the Pilot Study were compelling and validated outcomes from previous PGx studies:
The PGx test results led to treatment change for over three-quarters of study participants, indicating that even with years of trial and error, the majority had still not found optimal treatment.
According to the treating Physician, having the Inagene insights sooner would have altered treatment “entirely” or “significantly” for over 65 percent of patients, and would have resulted in all 50 patients arriving at a more effective treatment regimen sooner.
It was also determined that having the test results sooner could have saved patients (on average) over 170 weeks of “trial and error” and over $3,000 in wasted drug costs.
The results from the pilot study will be used to raise awareness and enable access to PGx testing for Canadians suffering from mental health and pain conditions, and to bring the cost-saving and productivity benefits to employees and employers in both the private and public sectors.
“Calian is excited to partner with Inagene to support innovative approaches in personalized healthcare. Reducing the time and cost of trialing medications for pain management and mental health treatment has the potential to significantly improve the well-being of Canadians.”
Gordon McDonald, President of Health Services at Calian.
“We need to think differently about how we are addressing treatment for those suffering from pain and mental illness. This pilot illustrates what is possible for Canadians living with physical or psychological pain and how their journey could be transformed for the better through the data-driven insights that pharmacogenetic testing provides.”
Nancy White, CEO of Inagene Diagnostics
References
In the segment, Dr. Tony Kiang, Assistant Professor of Translational Pharmacotherapy at the University of Alberta explains that “Currently, drugs are prescribed empirically for most cases, which means that most people would get similar dosage, (with pharmacogenetic testing) the doctor or the pharmacist can tailor the medication and the dosage to the patient, based on their genetic information.”
Understanding how her genetic information would affect her medication response was the driving force behind Nurse Debbie Roberge ordering her Personalized Insights™ Report from Inagene Diagnostics. With a simple cheek swab, Debbie was able to unlock, and now share these insights with her healthcare teams so they can personalize her treatment and recovery plans now and into the future.
Inagene Diagnostics continues to drive awareness of PGx testing to empower Canadians in their journey with pain and mental health.
Learn more about Debbie’s story and the future of drug prescribing: https://globalnews.ca/news/7860585/pharmacogenetic-testing-drug-prescriptions/
]]>Clarigent Health supports medical professionals by leveraging the power of Artificial Intelligence (AI) to isolate vocal biomarkers that signal potential mental health risks, supporting clinical decisions and workflow efficiency.
The 40-minute conversation covers some of the mental health challenges presented by COVID-19, and how they impact students.
Learnings from Episode 4 include:
This episode raises awareness regarding the various solutions available to support mental health treatment, guide lifestyle choices and selecting the right medication.
Watch Episode 4 on Youtube or listen to the audio through Spotify!
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Quebec’s only bilingual health and wellness magazine, MONTRÉAL enSANTÉ, is filled with expert advice from physicians, dietitians and personal trainers. Each issue aims to empower its audience with a focus on health, nutrition, and fitness.
The publication presents the most up-to-date health research by having an entire section dedicated to the innovative clinical care and cutting-edge research taking place at the McGill University Health Center.
Inagene Diagnostics appeared on the Spring 2020 issue, raising awareness about the empirical power of personalized pain management for all Canadians. Also featured in the issue is Canadian-Belgian singer-songwriter Lara Fabian as well as women’s health topics including migraine and misconceptions, strong is the new sexy, joint and health pain management, and more.
Click below to access the Spring 2020 issue in both English and French:
]]>The webinar is now available on-demand free of charge to all pharmacists interested in learning more about pharmacogenomics and integrating pharmacogenetic testing as a value-added service, and tool to help patients optimize their experience and outcomes with medications.
The webinar provides an overview of the basic principles and benefits of Pharmacogenetic testing, supported by real-world case examples, and key success factors in implementing pharmacogenetic testing in pharmacy.
To register for Pharmacy U Vancouver 2020 sessions on-demand please follow these steps:
If you are already registered, please use this link to directly access the session: https://matchmaking.grip.events/pharmacyuvancouver/app/session/52121.
If you have any questions regarding Pharmacogenetic testing, please contact us at info@inagene.com
]]>In this episode, Nancy and Lois explore health through the lens of genetics, personalized medicine and prevention in order to help listeners make the best decisions to live their healthiest lives in the context of the COVID-19 pandemic. Specifically, how our genes play a vital role in virus susceptibility, responses to treatments used, and ultimately disease outcome
“There's a lot we can learn through our genetics and how you can take preventive action to keep you and your family safe. We want to start with talking about prevention because an ounce of prevention is worth a pound of cure,” Nancy states.
Lois introduces immunePower, a tool to understand the common genes that have been linked to COVID-19.
A few highlights of the second episode are:
Watch the third episode on Youtube or listen to the audio through Spotify!
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For Canadians, the dark and chilly winter months typically bring an increased focus on protecting ourselves from getting sick. But as we navigate through the winter months of the COVID pandemic, doing everything we can to protect our health has never been a higher priority.
With this in mind, Inagene is proud to announce the launch of a brand new pharmacogenetic test: Inagene Personalized Insights™ PrecisionRx reveals predicted responses to over 160 medications spanning across multiple therapeutic areas (including cardiology, endocrinology, immunology, gastroenterology, infectious disease, urology, oncology and more), including drugs most commonly used in a hospital setting.
More than 98% of us unknowingly carry gene variants that will cause us to have an unexpected reaction to one or more commonly used drugs (a lack of or reduced clinical effect and/or unexpected side effects or safety risks). Gene – driven variations in response to drugs can make finding the best treatments and doses difficult, time-consuming, and even dangerous, and this risk is greatly heightened in the event of a hospital admission.
The typical critically ill patient is prescribed a myriad of medications, many of which can cause overlapping side effects and unnecessary harm. Because these patients are particularly vulnerable, time is of the essence in finding the most effective treatments and doses, and avoiding adverse drug reactions is extremely important. A recent study confirmed that most patients hospitalized with COVID-19 end up receiving at least one medication that is affected by pharmacogenetics, and many receive several. Without knowing how individual patients are likely to respond to different drugs this upfront, physicians are left with no option but to “try out” different medications and doses, which can mean losing valuable time and exposing vulnerable patients to potential safety risks.
Even under “non-pandemic” circumstances, adverse drug events are the #4 cause of death in Canada, cause one-third of hospitalizations and 20% of in-hospital injuries, and significantly lengthen hospital stays for those admitted. Up to 80% of adverse drug events are estimated to be the result of inherited genetic variations that people unknowingly carry.
A recent study looking at patients hospitalized with COVID 19 demonstrated that having pharmacogenetic test results to guide treatment provides opportunities to optimize clinical care for nearly all individuals hospitalized with the virus. By revealing predicted responses to drugs commonly used both in and outside of the hospital setting, Personalized Insights PrecisionRx provides invaluable insights that help guide prescribers to the most effective and safe drugs and doses for each individual, while avoiding the rest.
During this second episode, Nancy and Lois walk viewers through the personalized reports from Inagene and dnaPower, using their own reports, and sharing real life examples illustrating how to get the most out of the insights provided. Each report is shown on the screen for viewers to get a sense of the product and how to get the most out of your personalized test results.
A few highlights of the second episode are:
Watch the second episode on Youtube or listen to the audio through Spotify!
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Inagene Diagnostics Inc. celebrates its new partnership with dnaPower Inc. by creating a series of informative videos and podcasts, available on the streaming platforms below.
In the first episode of The HealthyHelix – Your Personalized Roadmap to Health, the series hosts Nancy White, CEO, Inagene Diagnostics, and Lois Nahirney, CEO, dnaPower share knowledge and relevant tools while discussing the latest trends related to personalized healthcare.
Join Inagene’s community of consumers who will be left with no doubt about the incredible power of DNA testing to empower individuals to achieve their best health and live their best lives.
We want to hear from you! If you have any topic suggestions, questions, or comments please reach us at health@dnapower.com
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On November 10th (3-4:30 EST), the Canadian Pain Society will present a webinar featuring Inagene’s Chief Science Advisor, Dr. Katherine Siminovitch, M.D., FRCP(C). She will be joined by renowned opinion leader in pain medicine and physiatrist/clinician, Dr. Andrea Furlan, MD, PhD, and expert pharmacist at UHN’s Comprehensive Integrated Pain Program, Laura Murphy BScPhm, PharmD, MSc, RPh. In this webinar, Dr. Siminovitch will outline the basics of the science of pharmacogenomics (PGx) and provide insight into the promise of PGx for pain medicine with the array of genes that may hold answers to important clinical questions. This webinar is/will be archive available to CPS members and non-members can pay a one-time fee to view it.
For more information: click here.
]]>Research has clearly shown that our DNA has a lot to do with our risk of developing certain pain and mental health conditions, as well how we experience pain (our unique “pain thresholds”), and even how we will uniquely respond to different medications. Equally interesting is that this is also influenced by our gender. A recent article published on the YMC (Yummy Mummy Club) network highlighted the surprising fact that women are at higher risk of certain pain and mental health conditions than men, and women also tend to experience higher pain severity. Women and men’s responses to medications can also vary, with certain drugs being more effective for women and others for men. More important, is that no two people are alike; you are unique and so is your response to medication. In this article, renowned Canadian physician experts and Pain Specialists Dr. Ian Finkelstein and Dr. Lydia Hatcher help shed light on this issue, and how pharmacogenetic testing uses our DNA to determine which medications and doses have the best likelihood of treatment success for each person.
Read the full article: click here
]]>Sue Paish, CEO, Canada’s Digital Technology Supercluster, moderated the panel discussion which included Fiona Dalton, President and CEO, Providence Health, Dr. Federica Di Palma, Chief Scientific Officer and Vice President, Sectors, Genome BC, Dr. Alexandra Greenhill, CEO and Chief Medical Officer, Careteam, Dr. Deepak Kaura, Chief Medical Officer 1QBit, and, our very own Nancy White.
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The Pain Society of Alberta is a multidisciplinary team of health care professionals who share a common interest in and commitment to the study, treatment, and management of pain. Their mission is to deliver high-quality, evidence-
If you missed us at the conference view the Inagene presentation here.
]]>Download the full article on pharmacogenetics and mental health.
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