A new blood test promises early detection of anxiety disorders, a blow against the old regime of simply interviewing patients, observing their behavior and making a diagnosis. The research team was led by Alexander Niculescu, a professor of psychiatry at Indiana University who has already developed similar tests for mood disorders and PTSD.
The new “BioM-95” test relies on 95 genetic markers identified during a detailed study that examines both patients and their body’s RNA, which stress and mental illness can alter. The promise of a rapid blood test is great: a 2005 study revealed one of the major flaws in psychiatry is that it often takes several years before someone suffering from mental illness receives treatment. In the case of anxiety disorders, the study found a particularly large delay of 9 to 23 years.
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Following the genes/test for anxiety
Researchers have already found many of the genetic markers in the test. But it wasn’t until Niculescu tested their predictive power as a whole that he discovered an important new one, ERCC6L2, which is common in anxious depressed patients. The gene has something to do with DNA repair and the functioning of mitochondria, the energy centers in cells.
“Reactivity and recovery may be key functions of anxiety,” learning says.
More importantly, Niculescu pitted the genetic approach against the traditional “structured interview” method of somehow questioning and assessing a patient about the severity of their illness. In real patients, the BioM-95 proved better at predicting future hospitalizations.
“The current approach is to talk to people about how they feel to see if they can take medication,” Niculescu said in a news release, “but some medications can be addictive and cause more problems.”
Neglected medications
The study found little genetic support for the use of benzodiazepine sedatives like Xanax and Valium, which can cause psychological dependence and a dangerous withdrawal syndrome. To search for alternative therapies, the study matched the genetic markers with drugs that also modified them and came up with a long list of recommended drugs, many of them unconventional. It’s at the top of the list valproatean old bipolar drug that increases the neurotransmitter GABA in the brain, which can have a calming effect.
Next is the powerful antipsychotic drug clozapine, used sparingly by doctors because it can affect the body’s white blood cells, among other things. More palatable treatments such as omega-3 fatty acids, meditation and Prozac also ranked highly, along with lithium, which reduces suicide risk.
Even more unusual drugs have shown genetic promise, such as thalidomide (long banned), a female sex hormone, a local anesthetic compound, the muscarinic substance atropine, a plant toxin, a heart drug, and loperamide, the anti-diarrhea drug that slows the bowel movement found in Imodium. Loperamide works by binding to opioid receptors in the peripheral nervous system and may cause constipation with long-term use.
In contrast, Stahl’s basic psychopharmacologyreserve in psychiatry, lists mostly antidepressants and benzodiazepines as treatments for anxiety disorders and does not mention valproate or lithium.
Niculescu’s Indianapolis-based startup, MindX Sciences, already offers blood tests for mood and anxiety disorders, pain, PTSD, suicide risk and memory, but patients must pay out of pocket. The company says it will pursue “Medicare and insurance coverage in the near future.”