Pharmacogenetic Testing
Pharmacogenetic testing analyzes genes that affect how you metabolize medication. In psychiatry it is used to inform medication selection and dosing — particularly for patients who have had poor responses or unusual side effects on multiple medications.
Is pharmacogenetic testing worth it?
Sometimes. It is a useful tool and it is not a crystal ball, and we would rather say that plainly than sell it as one.
What the testing does reliably: identifies variants in liver enzymes — principally CYP2D6 and CYP2C19 — that determine how quickly you metabolize certain medications. If you are a poor metabolizer, standard doses can produce side effects at levels others tolerate. If you are an ultra-rapid metabolizer, a standard dose may never reach a therapeutic level, which can look identical to “this medication doesn’t work for me.”
What it does not do: tell you which medication will make you feel better. Psychiatric response is driven by far more than simply metabolism, and no current test predicts efficacy with the confidence the marketing implies.
Who should consider it?
- People who have tried several psychiatric medications without adequate response
- People who consistently experience side effects at doses others tolerate
- People who have had an unusual or severe reaction to a psychiatric medication
- People starting medication who want the additional information before beginning
If you have responded well to your first or second medication, testing is unlikely to change anything, and we will say so.
What does the test involve?
A cheek swab collected in our office. Results typically return within a couple of weeks and are reviewed with you at a follow-up visit. The report groups medications by how your metabolism is likely to handle them, along with dosing considerations and interaction flags.
The results are permanent. Your genotype does not change, so the report remains useful for the rest of your life — including for medications prescribed outside psychiatry.
How is the result actually used?
As one input among several. A pharmacogenetic report does not override clinical judgment, treatment history, or your own experience of what has and has not worked.
In practice it is most useful for explaining something puzzling — why a medication that should have worked did not, or why a low dose produced disproportionate side effects. Understanding the mechanism often changes what we try next.
Does insurance cover it?
Testing is billed directly by the laboratory rather than through us. Coverage varies considerably by carrier and by indication. We will tell you what the test costs before ordering it, and it will not be ordered without discussing whether it is likely to change your treatment.
Does this require an in-person visit?
Yes, for sample collection. The consultation before and the results review afterward can both be done by telehealth.
Related: medication management and ADHD evaluation, where stimulant metabolism is frequently relevant.
Treatment in Glendale and across Arizona
We see patients in person at our office in Glendale, in the Arrowhead area, and by telehealth anywhere in Arizona — Tucson, Flagstaff, Prescott, Yuma, Sierra Vista and everywhere between. Virtual visits are the same appointment with the same provider at the same fee.
Getting started
New patient evaluations are $375 and run 60 to 90 minutes. Follow-up visits are $125. We are out-of-network with all insurance and provide a superbill you can submit for reimbursement. Full detail on our fees page.
Pinnacle Psychiatry · 17505 N 79th Ave, Suite 309, Glendale, AZ 85308
Phone 623.321.2221 · Text 877.749.7502
Monday–Wednesday 8:00am–5:00pm · Thursday 7:00am–5:00pm