Published on July 4th, 2014 | from CAMH
The future is here: My experience with personalized medicine
by Larry Meikle
My name is Larry Meikle. I’m a retired Ontario civil servant and a student in the University of King’s College Master of Fine Arts program in Creative Nonfiction Writing, where I’m in the process of writing my first book.
This past year I’ve felt better than I have for decades. I would not be a graduate student today if I were feeling the way I did even a year ago, had I not participated in CAMH’s IMPACT study on mental health problems and DNA.
I was diagnosed with clinical depression in 1997 and since then I’ve been taking antidepressants, with some degree of success. I tried going off my meds on a couple of occasions in the hope I could battle depression without them, but came to the painful realization I couldn’t.
A couple of years ago the antidepressant I had been taking for so many years suddenly stopped working for me. It “pooped out,” as the saying goes. My family doctor started me on a new medication, and that seemed to go reasonably well. Whenever I saw my doctor I’d tell him I was “getting by,” but anxiety was still a problem and I felt I could be doing much better.
My doctor suggested trying yet another medication, but I dreaded facing the slow and painful process of winding-down one med, then slowly building up the dosage of a new one. And what if it didn’t work? There was no guarantee the new antidepressant would work any better for me than the previous one had; in fact, it may leave me feeling worse. Changing meds was a “crap shoot”—a roll of the dice.
When I learned of CAMH’s research project involving genetic testing and depression in the fall of 2012 I mentioned it to my doctor on my next appointment. I told him I’d like to participate in this study, in the hope that it may help me find a medication that was “right” for me. He was very receptive and enthusiastic about my suggestion, and told me to leave it with him.
In January 2013 I was advised that I’d been accepted into the research study. Not only that—my family doctor’s practice was going to be the site of the official “rollout” of the study to the Ontario public at large, and I would be the first subject genetically tested in this roll-out.
Being a subject in this study was a breeze. Later that month I made a doctor’s appointment to have a saliva test taken by CAMH staff. Two days later I had the result of my genetic testing. The test results listed a number of common antidepressants in “green”—these are the ones my body would metabolize well, with little chance of experiencing negative side effects.
Other antidepressants were listed in “yellow,” advising my doctor that they may not be as effective for me. Fortunately the drug I was currently using was in the “green” area, a perfect fit for me.
I had a meeting with my doctor right after we were given my test report. When I told him again I thought I could be feeling better than I had been, he suggested two options—one, was to choose another antidepressant from the ones listed in “green,” the second was to consider increasing the dose of my current medication. He told me he would not have been confident in increasing the dose of my current drug prior to having seen my test results.
It was an easy choice for me. I asked to have my dosage increased, and he slowly increased my dose and tracked my progress until we reached the point I’m at today, taking double the dose I was a year ago and feeling much, much better for it.
Some feelings of depression linger, as I expect they always will, but the anxiety I used to feel has been dramatically reduced.
CAMH’s DNA test played a significant role in enabling me to get my life back on track, and now millions of Canadians with depression will have the same opportunity afforded me. I believe this genetic test is an exciting new tool, for patients and their doctors, in the treatment of depression.
I’m telling my story in the hope it will inspire more public discussion of depression, thereby reducing the stigma associated with this illness.
Will you add your personal story to this conversation?