Genetic Testing for ADHD Medications: A Primer

For years, scientists have explored the genetic basis of ADHD, which has enabled them to develop a genetic database for the disorder. Through their investigations, they have learned that ADHD is highly heritable and that genetics contribute to this tendency for ADHD to be shared between family members.

While there may be genes that increase one’s risk of developing ADHD, genetics may also provide information on how one’s ADHD will progress. Genes may too affect how people with ADHD are influenced by specific therapeutic interventions. This information could be enormously powerful in eliminating unnecessary or unhelpful treatment strategies for individual patients.

Choosing ADHD Medications Isn’t Always Simple

A common frustration for people with ADHD and parents of those with ADHD is the trial and error that tends to be involved in identifying the best course of treatment. Not only are there distinct approaches to the disorder – ranging from lifestyle modifications to pharmacological intervention – but there are several choices within each treatment category.

For instance, those who opt to address ADHD with drugs must choose between non-stimulant and stimulant drugs and then choose from a variety of specific drug choices. To make things even more complicated, dosing must then be balanced to ensure the drug achieves its effects without unwanted side effects. Even once the “right” drug is identified, figuring out the best dose can be time consuming and unpleasant, and dosing needs may change over time, exacerbating these problems.

Genetic Testing Could Reduce the Guess Work

Now, thanks to advances in genetics, there is a new way that people with ADHD can approach treatment and potentially avoid the inconveniences, disappointments, expenses, and adverse effects associated with trying several different therapeutic options. By performing genetic tests on individual patients with ADHD, the hope is that experts will be able to better predict how each patient will respond to a given intervention. Avoiding arbitrary choices and taking the guess work out of ADHD treatment should theoretically allow patients to determine their optimal treatment strategy much faster than has previously been possible.

What Information Does a Genetic Test Provide?

Genetic testing aims to determine the specific ways that an individual patient will respond to treatment, which could vary based on, for example, how a patient metabolizes a specific ADHD medication. Intervention protocols in medicine are often based on “average” responses, but there is a great deal of individual variation in how therapies affect patients. In recent years, there has been a push to recognize the fundamental weaknesses in many one-size-fits-all approaches to disease, a notion that has been bolstered by President Obama’s Precision Medicine Initiative.

Data on the specific ways that an individual’s genes could provide information on the impact of specific ADHD medications is accumulating. Research has shown, for instance, that genetic variations that lead to differences in the way the chemical serotonin behaves in the brain can help to accurately predict how patients will respond to methylphenidate, more commonly known as Ritalin.

The Future of Genetic Testing

It is clear that people with different gene variants may experience ADHD differently, which suggests that the appropriateness of any given intervention varies from person to person. There are currently clinical trials underway in which gene variants are being used to test the effectiveness of different ADHD interventions. Research is also exploring how genetics could provide other information that could be useful for ADHD patients, such as what genes can tell us about how susceptible an adolescent with ADHD may be to nicotine addiction.

More research is needed for us to understand the true potential of genetic testing to help ADHD patients figure out their best approach to treatment. The specific uses and value of genetic testing will likely evolve over time as we learn more about the genetic basis of the disease and what relevant information we can glean from genetics. For now, there is hope that we can use genetic testing to enable people with ADHD to better manage their symptoms in a fast and easy way.