• Individualized Medicine

    Test reveals the right drug to help one patient manage panic attacks – finally

Nicole Carlos

When it comes to medications, one size does not fit all. One of the areas where precision medicine has made the biggest impact is in developing tests to help physicians identify which medication will provide the greatest benefit and reduce harmful side effects for patients. Pharmacogenomics tests show how a patient’s genetic makeup impacts the way they process medications. These tests can help physicians select the right drug at the right dose for the right patient. They can also help identify why a medication is not working as intended

That’s how Nicole Carlos was finally able to find a solution to manage severe heart pounding panic attacks she had experienced for years. She was receiving care at Mayo Clinic for a chronic liver condition, primary scleroscing cholangitis, when her doctor, Konstantinos Lazaridis, M.D., recognized that her medication may not be managing her panic attacks.

Dr. Konstantinos Lazaridis

"We were talking about the importance of precision medicine when I mentioned to her that we now had a clinical test that can assess nine genes to identify a blueprint of how people metabolize medications," says Dr. Lazaridis, the Everett J. and Jane M. Hauck Associate Director, Mayo Clinic Center for Individualized Medicine, and the William O. Lund, Jr. and Natalie C. Lund Director of Clinomics, at Mayo Clinic’s campus in Rochester, Minnesota. "Immediately Nicole jumped in and said she wanted to know about whether the test could help her understand if some of her symptoms were due to her medication."

In fact, Nicole was the first patient to take the tests that had been developed by Mayo Clinic Center for Individualized Medicine. The tests revealed that she was metabolizing her anti-anxiety medication too quickly and was therefore not getting the full benefit of the medication. The test also gave Nicole and her doctors information they can use to adjust the dose of other medications she may need in the future.

To help Nicole manage her panic attacks, doctors developed a medical treatment plan based on her genetic information and found the drug that would be most effective for her. She transitioned to a new medication and her panic attacks went away. With the new medication, Nicole was able to better manage her own chronic liver condition and cope with the death of her father, who had also suffered from liver disease.

Read more about Nicole’s story.

Learn more about the impact of pharmacogenomics on patient care

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