GeneSight testing in psychiatric care
GeneSight is a cheek swab test that shows how a person's genes may affect the way their body processes many psychiatric medications. I order it by telehealth for patients in Pennsylvania, New Jersey, Florida and Oregon when the results are likely to help choose or dose a medication.
- What it looks at
- How genes may affect the processing of more than 60 mental health medications
- Sample
- Cheek swab, collected at home with a mailed kit
- Results
- Usually about three days after the lab receives the sample
- Cost
- Billed directly by GeneSight. Self-pay price $330, and no one pays more without agreeing first
The benefits of GeneSight testing in psychiatric care
For people whose medications have not helped, or have caused side effects that were hard to live with, GeneSight testing can add useful information. The main benefits are:
- It shows how genes may affect the way the body breaks down many antidepressants and other psychiatric medications.
- It can help narrow the next choice after one or more medications did not help or were hard to tolerate.
- It can inform dosing for some antidepressants, based on published CPIC guidelines.
- The results do not change, so they can guide future medication decisions too.
The limits matter just as much. Research on improved outcomes is mixed, the test cannot tell which medication will work best, and it is usually not needed before a first medication.
- Use as directed (green): no gene-drug interaction is expected to change how the medication is used.
- Moderate interaction (yellow): the medication may still be used, sometimes with a dose change or closer monitoring.
- Significant interaction (red): the medication may still be an option, but a different dose or a different first choice is often considered.
A medication in the yellow or red group is not off limits. The groups are a starting point for a conversation.
What the research shows
Testing may modestly improve the chance of feeling better for some people, especially after earlier medications have not worked. Full details and references are in GeneSight Testing: What It Can and Cannot Tell You.
GUIDED trial, 2019
In more than 1,100 adults with depression after at least one unsuccessful medication, test-guided care did not significantly improve average symptom scores at eight weeks. Response (26.0% compared with 19.9%) and remission (15.3% compared with 10.1%) rates were higher than with usual care.
JAMA Network Open, 2026
SSRI prescribing guided by CYP2D6 and CYP2C19 results, without GeneSight, did not change symptoms at three months, but remission was higher at six months (48.3% compared with 39.4%).
APA workgroup review, 2024
The review concluded that current evidence does not support routine testing for everyone treated for depression. The FDA has also cautioned against relying on these tests alone to choose an antidepressant.
How testing works
Who may want to consider it
- People who have tried one or more medications that did not help enough
- People who had strong side effects at usual or low doses
- People choosing among several reasonable options who want more information
Testing is usually not needed before a first medication trial, and it should not delay treatment.
The process
- We decide together at a visit whether testing makes sense.
- I place the order, and GeneSight mails a collection kit to the patient's home.
- The cheek swab takes a few minutes and goes back in the included packaging.
- Results usually reach me about three days after the lab receives the sample.
- We review the report at a visit before any medication change.
Cost
GeneSight bills patients directly. My practice does not charge a separate fee for the test and does not add a markup. Every patient can choose the $330 self-pay rate, and if insurance would leave a balance above $330, GeneSight makes contact before running the test. Income-based assistance and interest-free payment plans are available.
The time spent deciding on testing and reviewing results is part of a regular visit. For patients in Pennsylvania and New Jersey who use insurance through Headway, visits are billed to insurance. Private pay patients pay standard visit fees, listed on Insurance & Fees.
- Diagnose a mental health condition
- Tell which medication will work best
- Check for allergies or for interactions between medications already being taken
- Replace a clinical evaluation
Some medications, such as bupropion, fluoxetine and paroxetine, slow the CYP2D6 enzyme and change how other medications are processed. This is one reason results are always reviewed alongside the full medication list.
Common questions about GeneSight testing
What are the benefits of GeneSight testing in psychiatric care?
GeneSight testing can show how a person's genes may affect the way they process many psychiatric medications, help narrow choices after medications have not worked or caused side effects, inform dosing for some antidepressants, and provide results that stay useful over time. Research on improved outcomes is mixed, so testing works best as one part of a careful evaluation.
Can GeneSight tell me which medication will work?
No. It predicts how the body may process a medication, not whether that medication will improve symptoms. That is why results are always reviewed alongside history, past medication trials and the current medication list.
How much does GeneSight cost?
GeneSight bills patients directly. The self-pay price is $330, and no one pays more than $330 without agreeing to it first. Insurance coverage depends on the plan. My practice does not charge a separate fee for the test.
Who should consider GeneSight testing?
People who have tried one or more medications that did not help enough, had strong side effects at usual or low doses, or are choosing among several reasonable options. It is usually not needed before a first medication.
Can GeneSight testing be done through telehealth?
Yes. I order the test after a video visit, GeneSight mails a cheek swab kit to the patient's home, and we review the results at a video visit. This is available to patients in Pennsylvania, New Jersey, Florida and Oregon.
How long do results take?
Results usually reach me about three days after the lab receives the sample. Medication changes are made at a visit, not based on the report alone.
Ask about GeneSight testing
Testing is discussed at a psychiatric visit. Book with insurance through Headway in Pennsylvania or New Jersey, or book a private pay evaluation in any of the four states. For questions, call or text (215) 559-9962.