Optimizing Medication for ADHD

The US still needs to focus more on Mental Health. A huge number of people still don’t receive mental health medication, and many experience adverse drug effects due to the trial-and-error in medication. Thus, the FDA itself has labelled some mental health drugs for genome-based administration. Knowing your genetic makeup helps in getting the most suitable drugs and dosages and may even help in prescribing the most efficient medication for ADHD (attention deficit hyperactivity disorder).

Should Medication for ADHD Be Genome-Based?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects both children and adults, leading to hyperactivity, difficulties in focusing or prioritizing things, and extensive & excessive emotional dysregulation. Treating ADHD (formerly known as attention deficit disorder and hyperkinetic disorder) often involves a combination of behavioral therapy and medication. Finding the right drugs and dosages can perhaps involve a trial-and-error process.

Based on our genetic makeup, drugs are metabolized in our bodies differently, e.g., the same dosage of Adderall (a drug for treating Adderall) may be feasible for a normal metabolizer and insufficient for a rapid metabolizer, thus ineffective. Genome-based treatments are tailored treatments that allow doctors to prescribe medication based on the genetic makeup, resulting in reduced trial and error. Let’s check what genome-based dosing is, its recognition by the FDA, and the most effective medications for ADHD.

What is Genetic Data and Genome-Based Medication?

Genetic data refers to information derived from an individual’s DNA, which is the genetic blueprint that dictates how our bodies function. This data can be obtained with a simple Pharmacogenomic testing, also known as PGx testing. provides insights into how genes influence everything from physical traits to the way we process medications. Every person’s genetic makeup is unique, and as a result, the way we respond to various drugs can vary.

Genome-based medication, or pharmacogenomics, is a branch of medicine that studies how genetic variations affect individual responses to drugs. By understanding a patient’s genetic profile, doctors can avoid drugs with potential side effects and select the most effective medication and optimal doses. This personalized approach can help save patients from adverse events and optimize treatments for conditions like ADHD.

Should Medication for ADHD Be Genome-Based?

While non-stimulant medications are also used to treat ADHD, stimulant medications like methylphenidate (MPH) and amphetamines are often prescribed to treat this condition. While these drugs are effective for many individuals, they don’t work for everyone, and finding the right medication can sometimes take months. The variability in treatment response is partly due to genetic factors, which influence how patients metabolize drugs and respond to them.

Order your non-invasive PGx testing kit today and pay in 4 equal chunks.

Here’s where genome-based treatment can make a difference:

• Personalized Treatment: By analyzing a patient’s genetic makeup, clinicians could choose a medication that is more likely to work for them and adjust dosages accordingly. For example, certain genes affect how well a person metabolizes stimulant drugs. Individuals with certain genetic profiles may metabolize the drugs too quickly, making them less effective, while others may metabolize them too slowly, increasing the risk of side effects.
• Avoiding Trial and Error: Currently, finding the right ADHD medication often involves a lot of trial and error. With genome-based treatments, doctors could have a more informed starting point, minimizing the time it takes to find the right medication and dosage for a patient.
• Reduced Side Effects: Genetic factors also play a role in how a person experiences side effects. Some individuals may be more prone to side effects from certain ADHD medications, such as sleep disturbances, anxiety, or increased heart rate. By considering genetic data, doctors can avoid prescribing medications that are more likely to cause adverse reactions, leading to better overall patient outcomes.

While genome-based medication is helpful in most mental health medications, medications for ADHD are still not labeled for such dosing by the FDA. However, there is potential for such treatments to become standard practice, but further studies and clinical trials are needed to fully understand the role of genetics in ADHD treatment and to develop guidelines for genome-based prescribing.

PGx testing process, background, and a list of drugs labelled by the FDA for genome-based dosing.

Best Medications for ADHD: Active Ingredients and How They’re Metabolized

ADHD medications are broadly categorized into stimulants and non-stimulants. Here are the most commonly prescribed ADHD medications and their active ingredients:

1. Methylphenidate (e.g., Ritalin, Concerta)

• Active Ingredient: Methylphenidate
• Metabolism: Methylphenidate is primarily metabolized by the liver through the cytochrome P450 system, specifically CYP2D6. The rate at which an individual metabolizes methylphenidate can vary based on their genetic profile, influencing the drug’s effectiveness and the likelihood of side effects.

2. Amphetamine Salts (e.g., Adderall, Mydayis)

• Active Ingredients: Amphetamine salts
• Metabolism: Amphetamines are also metabolized in the liver, and their rate of metabolism can vary between individuals. Genetic variations in the CYP2D6 enzyme can significantly affect how quickly the drug is processed, leading to variations in drug efficacy and side effects.

3. Atomoxetine (Strattera)

• Active Ingredient: Atomoxetine
• Metabolism: Atomoxetine, an FDA approved drug for treating ADHD, is primarily metabolized by the liver, specifically by CYP2D6.

Genetic variations in CYP2D6 can impact how well the drug works for an individual. Slow metabolizers may experience higher drug levels, increasing the risk of side effects, while fast metabolizers may not achieve the required results with a moderate dosage.

Conclusion:

Most mental health drugs, including the medications for ADHD, tend to affect individuals differently. Enzymes are involved in metabolizing drugs, thus, a person who is a poor metabolizer of any specific medicine may require a lower dose. Inversely, a rapid metabolizer may require a higher dose of the same drug for a successful treatment. Pharmacogenomic testing from RPh LABS is non-invasive and can help your doctor tailor the drug and dosage according to your genetic makeup, reducing errors and expediting treatment.