Hi BSM,
Bumping this thread for hijack, possible discussion.
We are knee-deep in depression here. There seems to be a pattern in which ragweed/mold allergies set off a cycle into depression. He recovers and then spring allergies start the whole thing again. Admittedly, I'm just guessing.
DS isn't taking an SSRI because he had a weird reaction to Prozac and I thought it would be best to try something different over a school break.
I brought this up before, and there was some interesting discussion about it: DS psychiatrist offers DNA testing to help make better predictions about drugs. We just had his cheek swabbed and will have a new treatment plan in a week or so. Here are some things psychiatrist explained (I am not educated in science, so may paraphrase poorly):
The tests will provide some information about what stimulant class is likely to work best, and what would be smart to avoid.
Ditto for SSRI and SNRI.
Ditto other psych meds (mood stabilizers, antipsychotic, etc.)
We will receive a lengthy written report--I saw a sample and it's really cool.
None of that is really new info, but here are a couple of bytes:
Psych said DS' depression could (possibly) be more bipolar than unipolar, since he has a lot of anxiety and irritability mixed into it. He said in kids, it presents differently, and having a fast, unusual response to low dose of Prozac is a clue. If so, med implications are different.
And, this is the most interesting thing of all (to me). Psych said that fully 90% of kids on autism spectrum have a defect in the "MTHFR" gene, that causes problems metabolizing folate (B9). If you google that, there is stuff all over the place, science-y and holistic-y, etc. I won't pretend to understand or explain this in any depth, but folate has a lot of neuro importance. Doc explained very intensely and what I came away with is: if there is a genetic defect, it can affect both how the brain produces and uses important neurotransmitters like dopamine, norepinephrine, serotonin.
The testing DS is having will let us know if he has the MTHFR defect, among other important things having to do with drug metabolism (there are all sorts of ways drug metabolism can go awry).
There is a "medicinal food" called Deplin (by prescription only) that somehow bypasses the folate problem for people with this issue. If you google that, you'll find all kinds of people raving about how much better their antidepressants worked when supplemented with Deplin. I have no idea if they are shills or how real any of this is, but it's encouraging to me because (as far as I know) there is no downside to taking it.
The psychiatrist said--I think, don't quote me--that you can't rely on serum folate levels to detect a deficiency, something about the blood/brain barrier. Or maybe I read that somewhere else.
Also, newer antidepressant meds Pristiq, Fetzima, etc., evidently work to increase production and re-uptake, so if there is a problem with one or the other, the person is covered at both ends. <--please take my explanation loosely and feel free to correct me, anyone, if I've said anything glaringly inaccurate.
This is a commercial website, but it's the one for the lab DS' psych uses, and he assures me this is based on Mayo Clinic science and not quackery: genesight.com
The test is $330. They will bill insurance first, and if insurance won't pay--the company has a sliding scale, based on income.
As far as I know, this does have to be ordered by a physician, and the physician would have to understand how to use the report to create a treatment plan. DS' psychiatrist said it helps him make better predictions. Not a miracle cure, but helpful--we are hoping. Less suffering and more information can't be a bad thing.
Obviously, I have no idea if any of this is going to be helpful for my DS and ordinarily wouldn't even share the information, since we have no experience at this point. Since it is (relatively) inexpensive and noninvasive, and it sounds like he could possibly be helped by something as simple as a vitamin(!) it felt worth putting out there.
