Personalized Prescriptions in Child Mental Health

Personalized Prescriptions in Child Mental Health

In the aftermath of the COVID-19 pandemic, doctors are seeing more kids and teens struggling with their mental health — and many are being prescribed medication as part of their treatment.

For a child who is suffering from anxiety or depression, the right medication can be transformative. Unfortunately, finding that right medication — and the right dose — isn’t always easy. Drugs can affect kids in different ways and studies show that almost half will not improve or, even worse will suffer an adverse reaction. For young people already trying to manage anxiety or depression, it’s not healthy. For their helpless parents, this trial-and-error process is heartbreaking to watch.

“Antidepressants take up to eight weeks to work,” says Dr. Chad Bousman, a pharmacogeneticist within the Alberta Children’s Hospital Research Institute (ACHRI) at the University of Calgary. Dr. Bousman and his team study how genes affect a child’s response to drugs — specifically those used to treat mental health issues. “If you have to wait that long to find out it doesn’t work, and then you have to move on to another medication and wait eight weeks more, you can see how that just isn’t helping patients or their families.”

With support from our generous community, Dr. Bousman has created Canada’s first evidence-based pharmacogenetic testing service in child mental health with the ultimate goal of helping families avoid this upsetting odyssey.

With referrals from physicians and clinics across western Canada, he and his team have collected genetic information from over 1,000 patients via a saliva sample. That DNA has been analyzed to identify who will metabolize selected depression/anxiety drugs properly, and who will not. Based on the patient’s unique metabolic profile, an informed recommendation around medications and proper dosage can then be provided to their clinician — potentially saving months of waiting and wondering if a drug is going to have the desired effect.

Feedback from clinicians and families has been overwhelmingly positive. Forty-eight percent of participants reported improved outcomes by taking prescriptions informed by the testing, with 42 percent experiencing a reduction in adverse drug reactions. Understandably nervous about putting their children on medication, parents report feeling comforted that the drugs will be selected based on their child’s specific genetic profile. Referring physicians are equally enthusiastic, stating that this testing makes it possible for them to provide more personalized care for patients.

NEW STUDY FOR ADHD MEDICATION

The success of this project has inspired another study aimed at identifying biomarkers to inform prescription of psychostimulants (specifically methylphenidate — commonly known as Ritalin) to treat attention deficit/ hyperactivity disorder (ADHD).

In collaboration with community pediatric clinics and Primary Care Networks, the research team aims to enlist 400 participants diagnosed with ADHD who have not previously tried methylphenidate, but are intending to start. Participants will provide baseline clinical measurements and after four weeks of methylphenidate treatment, they will provide a saliva sample for DNA analysis, a blood sample to assess methylphenidate levels and a repetition of the initial clinical measures.

Through this study, the team seeks to unveil genomic profiles that exhibit positive responses to the treatment, as well as those that either do not respond well or experience significant side effects. Ultimately, the insights gained can be used by clinicians to enhance their treatment strategies for children with ADHD.

UCEED Child Health and Wellness Fund

While findings from Dr. Bousman’s studies are being published in notable medical journals, he knows it is equally critical to get this information into the hands of frontline practitioners. Engaging software engineering colleagues across campus, he created “Sequence2Script” — a program that analyzes all pharmacogenetic medication guidelines against patient genetic information and produces an easily understandable report for both patients and healthcare providers. This web-based offering was developed with support from the UCEED Child Health and Wellness Fund — an early-stage investment fund backed by donors to the Alberta Children’s Hospital Foundation who want to make a positive economic and community impact by helping UCalgary researchers get their discoveries to market. Read more.

This story appears in our Spring 2024 Just 4 Kids newsletter. Make sure you check out the other amazing stories!
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