Finding the best pain meds-genetically
 

Just about everyone that frequents this forum has wondered what is the best pain med for them. After all, we are all different and what works for one, may not work for someone else. Well, there is a reason for this and it comes down to genetics. Just as there are other genetic testing to see how people metabolize certain medications, there is NOW one for specifically for pain meds!!

Two months ago at my regular pain mgmt appointment, my doctor asked if I wanted to be a participant in a study for this type of DNA genetic testing strictly for pain medications and how an individual will respond. I agreed. It was a simple saliva swab test and I got the results this past visit.

The test literally breaks down numerous drugs in many classes to see how you (personally) will respond to each class. It covers everything from all the anti-seizure meds (Neurontin, Lyrica etc), to anti-depressants used for pain mgmt (Cymbalta, Nortriptyline, etc), anti-depressants in general (SSRI's, SSRI's, Tricyclic's, etc), to Opioids (all classes), NSAIDS, (All classes). It also assesses your risk for addiction, and pain perception. It looks at metabolism of all these drugs and how likely you are to personally going to respond to each drug & class.

This information is designed to help physicians better prescribe the right medication for each individual without the guess-work and trial/error. Just think of the time saved by knowing the FIRST time whether a drug has the potential to help...instead of taking 3 months of small increases of Neurontin only to find out it doesn't work and then have to taper off slowly before trying the next drug. This is what you can possibly avoid. I have tried many different medications over the last 19 years (20 yrs next month) and oh how this information would have been SO helpful long ago. I now have a fairly good pain mgmt program, but the test results did confirm why some of medications I tried over the years gave me horrible side-effects or just didn't work at all for my pain. I also learned (should I need) what meds will best suit me in the future should I need to change my current program...without the guess-work.

The company that did my testing is called Proove Bioscience and can easily be found online. It was a study program, so all costs were covered and there was NO out of pocket for me. My understanding (from my pain mgmt doctor) is that MANY physicians are turning to these tools to help their patients get the best pain mgmt possible. So I would suggest you ask your physician about this program and whether you can get on board. It's simple, no cost, and very informative. I'd post the site, but I'm not sure about the rules for doing so on this forum...but easy enough to find them on your own, or to ask your doctor.

Hope this information is helpful. For those of you currently trying to find the right medication (and/or dose) please ask your doctor about this. One of the things I learned is not just what medication may/may not work, but also whether higher or lower doses of a certain drug may be necessary due to enzymes and metabolism specific to my DNA. Just good information all the way around!!

Thanks en bloc

Very useful to read of someone who's been through this testing.

I've just e-mailed the company to find out if they offer the testing internationally and also what it would cost for those not covered by a US Medical Insurance scheme.

I note from your post that under the study it seems you got a range of tests, but that it also appears they can be ordered as different groups of tests. eg Drug Metabolism, NSAID Risk, Pain Perception etc.

I'll update any info of interest for those of us offshore if I get a response from Proove Bisciences.

This topic is expanding rapidly now, from the initial introduction of individual testing that was developed about a decade ago.

Here is another thread here at NT about another form of this testing:

http://neurotalk.psychcentral.com/sh...hlight=dimarie

Bluesfan,

All the tests that I mentioned where done with ONE saliva swab and panel. It is the standard panel of tests they offered me at the request of my pain mgmt doctor. I have no idea about international testing, but hopefully you'll post their reply here so others will know.

I will say the Medicare covered the cost of my test as well as my secondary insurance. But I was told if there was any balance, it would be picked up by the study. They went over the results in detail at my next visit and provided me with a printed copy of the entire panel of results so that I can share it with my other doctors.

Let me add to MrsD's comments. Yes, this is a very hot and expanding topic right now. There is, in fact, other programs for testing of medications, but these are typically limited to checking whether the patient can properly metabolize the medication (and if yes, then it can be assumed they can benefit from the medication). The program by Proove Bioscience for pain medications (and anti-depressants) does this, but also goes a big step further. It tests at the receptor level and therefore can predict the response by the patient. This makes a huge difference in prescribing pain medications...when needing to know whether it is 'likely' to help is a key factor.

I learned this with Proton Pump Inhibitors. I was not responding at all to the normal dose, and all my gastro said was to keep taking it. It was my pharmacist who advised me to double the dosage at which point I started seeing improvement.

23andme testing eventually told me I was a "fast metabolizer" and would likely need a higher than normal that dosage.

I'm glad at least my pharmacist was on top of things. :rolleyes: