Genetic Testing and Medication Management: How It Improves Treatment Planning

Ashley Keays • March 31, 2026

Finding the right antidepressant is, for many people, a frustrating process of trial and error. You try a medication, wait four to six weeks to assess whether it’s working, adjust the dose, manage side effects, and if it doesn’t work, start again with something else. For patients with treatment-resistant depression, this cycle can stretch across years.


Pharmacogenetic testing - genetic testing applied to medication selection - is one of the more meaningful advances in psychiatric care precisely because it addresses this problem directly. At Creative Wellness TMS, we offer genetic testing as part of our integrated approach to treatment planning. This article explains what it is, how it works, and when it’s most useful alongside TMS and medication management.



What Is Pharmacogenetic Testing?


Pharmacogenetics is the study of how your genes affect your response to drugs. The same medication at the same dose can produce very different outcomes in different people - some respond well, some experience significant side effects, and some metabolize the drug so quickly or slowly that it never reaches a therapeutic level in the body.


These differences are largely genetic. Variations in specific genes - particularly those governing liver enzymes responsible for drug metabolism - determine how your body processes psychiatric medications. By analyzing these genes, clinicians can make more informed decisions about which medications are likely to work for you, which are likely to cause problems, and at what dose.


At Creative Wellness, the test examines 18 genes relevant to psychiatric medication response. It is completed across two appointments: a sample is collected at the first session, and results are reviewed with your clinician approximately two weeks later.


Learn More: Genetic Testing Explained: Why We Offer It & What It Changes



What the Results Actually Tell Your Clinician


Genetic test results are typically presented in categories that reflect how your body is likely to process specific medications:


  • Poor metabolizers process a drug more slowly than average, meaning standard doses can accumulate to levels that cause side effects.


  • Rapid or ultrarapid metabolizers clear the drug too quickly for it to reach effective concentrations, which can explain why a medication appears not to work even at standard doses.


  • Normal metabolizers fall within the expected range, meaning standard prescribing guidelines apply.


This information is applied across the main classes of psychiatric medication - SSRIs, SNRIs, tricyclics, antipsychotics, mood stabilizers, and others. It tells your clinician which drugs from each class are likely to be well-tolerated and effective, which to approach with caution, and which to avoid.


It is worth being clear about what the test does not do: it does not predict with certainty that a specific medication will work. Genetics is one factor among several - diagnosis, symptom profile, lifestyle, and other medications all play a role. But it substantially narrows the field and gives prescribing decisions a more solid foundation than symptom history alone.

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Who Benefits Most From Genetic Testing?


Genetic testing is not only for patients who have already struggled with medication. It is useful across several situations:


  • Patients starting medication for the first time, where testing can help identify the most appropriate drug and dose from the outset, rather than relying on a standard starting point.


  • Patients who have experienced significant side effects on previous medications, where genetic results can explain why and guide a safer alternative.


  • Patients with treatment-resistant depression who have tried multiple antidepressants without adequate relief, where testing may reveal that the issue is metabolic rather than simply a mismatch of drug class.


  • Patients on multiple medications where drug interactions are a concern, as genetic data can flag potential risks.


Genetic variation that affects drug metabolism is present in the vast majority of the population - this is not a niche test for edge cases. Most patients benefit from having this information, even if only to confirm that standard prescribing is appropriate for them.

How Genetic Testing Fits Into a TMS Treatment Plan


This is where the integrated care model at Creative Wellness becomes particularly relevant. TMS and medication are not competing treatments - for many patients, they work best together. TMS addresses the neurological dimension of depression by directly modulating brain activity. Medication addresses the neurochemical dimension. When both are calibrated properly, outcomes are generally stronger and more durable.


The problem historically has been that medication was being prescribed without full information. A patient pursuing TMS may have already cycled through several antidepressants that weren’t well-matched to their metabolism - and may be continuing with a medication that is similarly suboptimal. Genetic testing can resolve this ambiguity.


Practically, genetic testing in a TMS context serves two functions. First, it helps ensure that any concurrent medication is the best available option for that patient. Second, it informs post-TMS planning - once a course of TMS is complete, many patients continue on a maintenance medication to preserve their gains. Having genetic data means that medication can be selected with significantly more confidence.


For patients who come to us with a history of multiple failed antidepressants, genetic testing often reframes the narrative. The failure may not have been the treatment approach - it may have been the specific drug or dose. That distinction matters both clinically and for the patient’s own sense of what is possible going forward.


Treatment Comparison: TMS, Counseling, Spravato, and Genetic Testing



The Process at Creative Wellness


Genetic testing at Creative Wellness is straightforward:


  1. Session one: A cheek swab or saliva sample is collected. No needles, no preparation required.
  2. The laboratory processes results over approximately two weeks.
  3. Session two: your clinician reviews the results with you, explains what they mean for your specific situation, and integrates the findings into your medication management plan.


The results become a permanent part of your clinical record. They do not change over time - your genetic profile is stable - so the test only needs to be done once. If your treatment evolves over the years, the same results remain relevant.

Coverage varies by insurance provider. Our team will check your eligibility before the test and let you know where you stand. Self-pay options are also available.

Interested in learning more?


Schedule a consultation to see if TMS could be right for you.

Visit our contact page or call 253-900-1605 to speak with our team.

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A More Informed Starting Point


The standard approach to psychiatric prescribing has always involved some degree of uncertainty. Genetic testing does not eliminate that uncertainty. Still, it reduces it meaningfully - and for patients who have already experienced the frustration of treatments that did not work, that reduction matters.


If you’re currently exploring medication options, considering TMS, or trying to understand why previous treatments haven’t delivered the results you expected, genetic testing is worth discussing at your next consultation. Contact Creative Wellness TMS to find out whether it’s right for your treatment plan.

  • Is genetic testing the same as a DNA ancestry test?

    No. Pharmacogenetic testing looks specifically at genes that govern how your body metabolizes psychiatric medications. It does not provide ancestry information, health risk predictions, or any of the outputs associated with consumer DNA tests.

  • How accurate is pharmacogenetic testing?

    The genetic analysis itself is highly accurate. What it cannot do is predict with certainty that a specific medication will be effective — drug response involves more than genetics. What it does do is give your clinician substantially better information than symptom history alone, which translates into more targeted prescribing decisions.

  • Will I need to stop my current medication before testing?

    No. The test analyses your genetic profile, which does not change based on what medication you are currently taking. There is no need to stop or adjust anything before your sample is collected.

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