A mind is a pattern of signals – memories and thoughts are emergent interactions from deep within the brain. Psychiatric medications alter those patterns to make them healthier, stronger, better. But all medications can cause adverse effects – and few are as potentially dangerous as psychiatric medications. Read the black box warnings about suicide and antidepressants and you'll see why psychiatry can benefit from personalized prescribing.

One of the technology’s most active vanguards is Dr. David B. Durham of the Sage Neuroscience Center in Albuquerque, New Mexico. Dr. Durham is a neuropsychiatrist who sees patients that span the spectrum of mood, psychiatric and neurological disorders - from depression to multiple sclerosis and traumatic brain injuries. Dr. Durham is also the Director of the Mosaic Brain Injury Laboratory, a Clinical Assistant Professor at the University of New Mexico, School of Medicine, and the Chair of the Board of Governors of the American College of Neurocognitive Medicine. He holds staff positions in multiple clinics across the state and serves as a consulting neuropsychiatrist at Sage Neuroscience Center.

Since 2012, Dr. Durham has been using YouScript to help him treat patients with potentially problematic medication regimens. YouScript helps him identify these patients ahead of time and prescribe safer, more effective treatments. Virtually all commonly-used psychiatric medications are processed by highly polymorphic enzymes tested by YouScript, including SSRIs, SNRIs, TCAs and atypical antipsychotics.

Even when away from the computer, YouScript continues to help Dr. Durham treat his patients. Dr. Durham says that, after using the program for a while, “you’re going to know that if you look at a combination of one or two drugs, what the alternatives are, and you’re going to know the generics… The software is a self-iterating teaching tool… It keeps you abreast of current pharmacology.”

Pharmacology is changing rapidly as pharmacogenetics is becoming incorporated into everyday practice. Staying knowledgeable about current developments not only ensures patient safety, it also allows prescribers to better justify medication choices.

Dr. Durham feels more confident defending himself in cases where he has to prescribe above-average dosage. “Every doctor’s going to have board complaints against them. If you don’t you’re either very lucky or… you’re being so safe that you're ignoring patient differences.” This is especially important for doctors prescribing pain medications. “If you're doing pain, you're taking a huge risk not to stay ahead of the curve.”

Doctors need to take the time to educate themselves about the latest developments in pharmacology and pharmacogenetics. “The key for a busy prescriber is you have to be selective about who you have time for,” says Dr. Durham, “[even] if you don’t have time, you keep a list of those you want to follow up on and you learn.”

Even with his busy schedule, Dr. Durham became adept at using the YouScript Personalized Prescribing software in about six weeks. Users, especially new ones, are encouraged to call Genelex's on-duty team of experienced personal prescribing pharmacists, who will quickly assist consult on the clinical implications of the YouScript Personalized Prescribing Report and determine the best course of action for your patient.

Pharmacogenetic technology is quickly advancing past the simplistic, single-gene testing of the past. Dr. Durham compares it to the days when medical imaging was starting to rise in popularity. Some, like him, use it as a general tool in their office. Others can use it selectively where they need it most. “But,” says Dr. Durham, when you consider the clinical, educational, and legal aspects, “you make a very compelling reason to use it regularly… This is going to exceed the standard of care.” A lot of patients could be saved time, money and pain if their prescribers personalized their psychiatric prescriptions.

“I think it’s the future,” says Dr. Durham. “I think that’s the way to go. Some of us have to be champions of new technology to help hold up the flag.”