SU83 - COMBINATORIAL PHARMACOGENOMIC TESTING IMPROVES GENERALIZED ANXIETY DISORDER TREATMENT RESPONSE AND DECREASES BENZODIAZAPINE USE

Abstract

Background Controlled substance prescription use and abuse in the United States has become a public health epidemic. Specifically, benzodiazepine abuse in 2013 has increased as much 400 percent since 1996. Generalized Anxiety Disorder (GAD) was the most frequent reason these medications were given, accounting for 56% of prescriptions. Previously, GeneSight, a psychiatric pharmacogenomic decision support tool, was reported to significantly improve depression symptoms in treatment-resistant depression patients, reduce costs associated with prescriptions, and decrease polypharmacy. Methods To evaluate the combinatorial pharmacogenomics report as a tool to treat GAD and reduce the amount of benzodiazepines used, we analyzed data from two separate studies: (1) Individualized Medicine: Pharmacogenetic Assessment and Clinical Treatment (IMPACT) study, a longitudinal pilot research program , where 315 participants with anxiety disorders (N=210 with GAD) and follow-up data on symptom severity using the GAD-7 questionnaire were identified; and (2) MEDCO dataset (Winner et al., 2015; Curr Med Res Opin.;31:1633-43) in which patients (n=660) who were prescribed at least one benzodiazepine six months pre-testing and were followed six months post-testing. Results The analyses in the IMPACT study sample showed that medication treatment decisions congruent with the combinatorial pharmacogenomics GeneSight test results can help guide clinician treatment of GAD and result in significantly more improvement of anxiety symptom severity (congruent: -44.9±35.9% versus non-congruent: -25.5±31.8%; t=2.19; p=0.031). In the MEDCO dataset, we found that 18% (n=116) of the patients originally taking at least one benzodiazepine pre-testing (n=660) ceased their use of benzodiazepines post-testing with a significant decrease in benzodiazepine drug counts and refills after testing (mean count 1.2 vs. 0.9; p Discussion The GeneSight test can lead to more effective treatment of the anxiety symptoms in GAD patients and may lead to beneficial decrease in benzodiazepine use.