OneOme RightMed® psychiatry report overview
The RightMed comprehensive test is a pharmacogenomic test that analyzes a patient’s DNA to determine how he or she may
respond to hundreds of medications. When a provider orders a RightMed test, they get the standard RightMed comprehensive
test report, plus access to optional reports, including the RightMed psychiatry report. Learn more about the RightMed psychiatry
report below, and then refer to the attached psychiatry report.
WHAT IS THE RIGHTMED PSYCHIATRY REPORT?
The RightMed psychiatry report includes a subset of psychiatric medications selected and classified by OneOme, including
medications used in the treatment of anxiety, depression, schizophrenia, bipolar disorder, and other mental health conditions.
Information about these psychiatric medications and a patient’s predicted response to them is presented in a streamlined,
consolidated view.
HOW IS THE PSYCHIATRY REPORT DIFFERENT FROM THE RIGHTMED
COMPREHENSIVE TEST REPORT (THE STANDARD TEST REPORT)?
Here’s how the RightMed psychiatry report and RightMed comprehensive test report differ:
MEDICATIONS: The psychiatry report only includes the medications selected and classified by OneOme that are used
to treat mental health conditions. The comprehensive test report includes hundreds of medications used in the treatment
of a wide range of medical conditions.
GENES: The psychiatry report includes only the gene and phenotype summary for the genes that have been shown to
impact the metabolism of the selected psychiatric medications. The comprehensive test report includes the gene and
phenotype summary for all genes analyzed by the RightMed test.
REPORT LAYOUT: The psychiatry report separates the medications by class (antidepressant, antipsychotic, etc.). The
RightMed comprehensive test report groups medications by the predicted gene-drug interaction. Download a sample
RightMed comprehensive test report at oneome.com/sample-report.
MAJOR AND MODERATE GENE-DRUG INTERACTION SUMMARY: The psychiatry report includes a summary of the
number of major and moderate gene-drug interactions for the psychiatric medications on the report. This allows the
provider to quickly visualize the number of medications that may be impacted for this patient.
HOW DO I GET THE PSYCHIATRY REPORT?
Providers can choose to add a complimentary psychiatry report either when they are ordering the RightMed comprehensive test,
or once the patient’s test results are completed. To get a psychiatry report after a patient’s results are in, visit portal.oneome.com.
WHAT OTHER REPORTS DOES ONEOME OFFER?
In addition to the comprehensive test report and the psychiatry report, providers can create custom RightMed Advisor reports
and also can get a RightMed oncology report—another speciality report available from OneOme. Download a sample RightMed
Advisor report at oneome.com/custom-report and a sample oncology report at oneome.com/oncology-report.
DO YOU OFFER SUPPORT WITH INTERPRETING RESULTS?
Yes. Providers and pharmacists receive access to complimentary, one-on-one consultations with clinical pharmacists from
OneOme. Contact support@oneome.com to set up a consultation.
I HAVE A QUESTION; WHO SHOULD I CONTACT?
We’d love to help. Please contact our customer support team at 844-ONEOME-5 (844-663-6635) or support@oneome.com. The
team will put you in touch with the right person.
© 2018 OneOme LLC. All rights reserved. OneOme and RightMed are trademarks of OneOme LLC.
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RightMed® psychiatry report
The RightMed psychiatry report is a specialty report available as part of the RightMed comprehensive test. It contains a subset of
medications selected and classified by OneOme for use in the treatment of anxiety, depression, schizophrenia, bipolar disorder, and other
mental health conditions.
Patient and report summary
Patient name: Jane Psych
Ordering provider: Sample Doctor
Patient date of birth: 1972-07-08
Ordering facility: OneOme Health
OneOme report date: 2018-01-31
Report type: Specialty
This report is based on OneOme's database as of the date this report was generated. The original test report issued 2018-01-22 remains
accessible through the provider portal at portal.oneome.com.
Major gene-drug
interactions
7 Antidepressant
1 Antipsychotic
1 Anxiolytic
0 ADHD
0 Other
Moderate gene-
drug interactions
3 Antidepressant
2 Antipsychotic
0 Anxiolytic
0 ADHD
1 Other
Based on the genes in our panel, medications are reported according to genotype-predicted interactions
Report legend
described below.
Major gene-drug
Major genotype-drug interaction identified that affects the metabolism of the medication and/or
interaction
indicates an elevated risk of adverse reaction or loss of efficacy.
Moderate gene-drug
Moderate genotype-drug interaction identified that affects the metabolism of the medication and/or
interaction
indicates an elevated risk of adverse reaction or loss of efficacy.
Minimal gene-drug
Minimal genotype-drug interaction identified that does not significantly impact medication
interaction
metabolism or predict an elevated risk of adverse reaction or loss of efficacy.
Limited genetic impact
No clinically relevant genetic variants are known to impact medication.
Some medications are reported with icons to indicate that specific clinical annotations and/or dosing guidelines
Icon legend
provided by the FDA and other professional associations are available in the RightMed Advisor.
Increased exposure
Total exposure to active compound(s) may be increased. Monitor for adverse effects.
Decreased exposure
Total exposure to active compound(s) may be decreased. Monitor for lack of therapeutic response.
Difficult to predict
Total exposure to active compound(s) is difficult to predict. Monitor patient response.
Response to medication may be lowered due to genetic changes impacting mechanisms other than
Reduced response
exposure (e.g. receptor function).
Additional testing
According to FDA labeling, additional laboratory testing may be indicated.
Medication has professional guidelines associated with this patient's genetic test results. Avoidance,
Professional guideline
dose adjustment, or heightened monitoring may be indicated.
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Genotype-derived recommendations for medications
Antidepressant
Major gene-drug interaction
Moderate gene-drug interaction
Minimal gene-drug interaction
Limited genetic impact
Amitriptyline
1, 2, 20, 100
Duloxetine
1
Bupropion 1
Desvenlafaxine 1, 13
Citalopram
1, 2, 6, 8, 15, 19, 22,
Selegiline
21, 32, 79
Desipramine 1, 2, 20
Milnacipran 1
23, 24, 27, 36, 37, 40, 42, 44, 50, 52, 55, 60,
Sertraline
1, 2, 14, 16, 19,
Fluoxetine 1, 18, 27, 31, 45, 49, 69,
65, 70, 71, 101
45, 57, 59, 62, 75, 77, 93, 98
74, 86, 104
Clomipramine
1, 2, 20
Fluvoxamine 1, 19, 30, 33, 34, 81,
Doxepin
1, 2, 20
82, 84, 85, 86, 89, 106
Escitalopram
1, 2, 6, 8, 15, 19,
Levomilnacipran 1
23, 24, 27, 40, 44, 50, 55, 60, 71, 101
Mirtazapine 1, 2, 38, 46, 88, 90
Imipramine
1, 2, 20, 99
Nefazodone 1, 76, 96
Trimipramine
1, 2, 20, 39
Nortriptyline 1, 2, 20, 64, 95
Paroxetine 1, 2, 19, 29, 35, 56, 72,
78, 86, 91, 103
Protriptyline 1
Trazodone 1
Venlafaxine 1, 2, 97
Vilazodone 1
Vortioxetine 1
Antipsychotic
Major gene-drug interaction
Moderate gene-drug interaction
Minimal gene-drug interaction
Limited genetic impact
Risperidone
1, 2, 26, 102
Asenapine
1
Aripiprazole 1, 2, 94
Paliperidone 1
Olanzapine
1, 2, 41
Brexpiprazole 1
Cariprazine 1, 3, 9, 12, 58
Chlorpromazine 1, 67, 87
Clozapine 1, 2, 47
Haloperidol 1, 2, 66, 83, 94
Iloperidone 1
Lurasidone 1
Perphenazine 1, 63
Pimozide 1, 94
Quetiapine 1, 92
Thioridazine 1
Anxiolytic
Major gene-drug interaction
Moderate gene-drug interaction
Minimal gene-drug interaction
Limited genetic impact
Diazepam
1, 28
Alprazolam 1, 92
Buspirone 1, 92, 107
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ADHD
Major gene-drug interaction
Moderate gene-drug interaction
Minimal gene-drug interaction
Limited genetic impact
Atomoxetine 1, 2
Clonidine 1
Guanfacine 1, 51
Other
Major gene-drug interaction
Moderate gene-drug interaction
Minimal gene-drug interaction
Limited genetic impact
Ramelteon
1
Armodafinil 1
Gabapentin 1
Carbamazepine
1, 4, 5, 10,
Lithium 1
11, 25, 43, 48, 53, 54, 61, 68, 73, 80, 105
Pregabalin 1
Dextromethorphan/
Temazepam 17
Quinidine 1
Eszopiclone 1
Modafinil 1
Propranolol 1
Tetrabenazine 1
Triazolam 1, 92
Zolpidem 1, 7, 96
Zonisamide 1
Genotype-derived classification of medications is provided as a service by OneOme and is intended solely for use by a medical professional who has reviewed
and understands all sections within this report, including possible limitations of the services provided by OneOme. The relationships between the drugs and
pharmacogenes annotated in this report are supported by scientific evidence that meets OneOme’s critieria for inclusion. The order in which drugs are listed does
not have any clinical or medical implications. For more information on these medications, for a list of additional medications curated but not annotated by OneOme,
or to evaluate possible drug-to-drug interactions, please consult the RightMed Advisor, which is accessible through the provider portal at oneome.com.
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Gene and phenotype summary
Gene
Genotype
Phenotype summary / Metabolic status
Rapid
CYP1A2
*1A/*1F
Increased activity. Drugs converted to active metabolite(s) may cause side effects or
toxicity. Active drugs converted to inactive metabolite(s) may lack efficacy.
Intermediate to Normal
CYP2B6
*1/*5
Decreased activity. Drugs converted to active metabolite(s) may have reduced efficacy.
Active drugs converted to inactive metabolite(s) may cause side effects or toxicity.
Intermediate
CYP2C9
*1/*3
Decreased activity. Drugs converted to active metabolite(s) may have reduced efficacy.
Active drugs converted to inactive metabolite(s) may cause side effects or toxicity.
Ultrarapid
CYP2C19
*17/*17
Increased activity. Drugs converted to active metabolite(s) may cause side effects or
toxicity. Active drugs converted to inactive metabolite(s) may lack efficacy.
Normal
CYP2D6
*1/*1
Normal level of activity. Drugs metabolized at a normal rate.
Normal
CYP3A4
*1/*1
Normal level of activity. Drugs metabolized at a normal rate.
Poor
CYP3A5
*3/*3
Normal dosing may be required because original dosing guidelines for drugs have been
established on patients with poor metabolizer phenotype.
Reduced response
Genotype is associated with a lower likelihood of improvement in schizophrenia
DRD2
rs1799978 GG
symptoms with risperidone compared to the AA or AG genotypes. Other clinical and/or
genetic factors may influence response.
Normal response
Genotype predicts a normal response to citalopram in patients with major depressive
GRIK4
rs1954787 CC
disorder related to the GRIK4 genotype alone. Other clinical and genetic factors may
influence response.
Intron 2 genotype AA
HTR2A
rs7997012 AA
Genotype predicts an increased likelihood of response to citalopram. Other clinical and
genetic factors may influence response.
Normal risk
HTR2C
rs3813929 CC
Genotype predicts a normal risk of weight gain with olanzapine treatment. Other clinical
and/or genetic factors may influence response.
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Gene and phenotype summary (cont.)
Typical to increased expression
Genotype predicts a typical to increased expression of the SLC6A4 transporter
compared to patients with other genotypes. The L/L genotype has been associated with
SLC6A4
L/L (La/La)
increased likelihood and potentially quicker response to the SSRIs fluoxetine,
fluvoxamine, and possibly citalopram and escitalopram. The opposite trend in response
has been observed in East Asian populations, showing increased likelihood and
potentially quicker response in carriers of the S allele.
CYP phenotype abbreviations
PM
Poor metabolizer
IM
Intermediate metabolizer
NM
Normal metabolizer
RM
Rapid metabolizer
UM
Ultrarapid metabolizer
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OneOme liability disclaimer
The interpretations and clinical annotations provided by OneOme are intended solely for use by a medical professional and do not
constitute medical advice by OneOme. The treating provider remains ultimately responsible for all diagnosis and treatment decisions for
the patient. Information included in this report is based upon scientific literature and does not take into account other genetic variants and
environmental or social factors that may affect a patient's response. Other factors not included in this report include, but are not limited to,
environmental factors (e.g., smoking), health factors (e.g., diet), social and familial factors, various medical conditions, and drug-to-drug
interactions. Administration of any medication, including the ones listed in the OneOme reports, requires careful therapeutic monitoring
regardless of the phenotype or genotype-derived recommendation. As a matter of practice, OneOme will routinely update its
pharmacogenomic database as new information becomes available to the scientific community. Drug binning and annotations found on
the patient's RightMed comprehensive test report, RightMed Advisor reports, or RightMed specialty reports are therefore dependent on
the date of generation and/or the database version used to generate that report. Providers may access these reports with updated
annotations using OneOme’s latest released version through the provider portal at portal.oneome.com.
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Patient date of birth: 1972-07-08
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