This session will focus on recent advances in genomics. Currently, pharmacogenomics is the main form of genomics used in psychiatric care. However, outcomes can be improved when genomics is also used to look at the underlying genomic contributing factors, of anxiety, including cortisol metabolism, nutrient pathways relating to the synthesis and binding of GABA, norepinephrine, and serotonin, and even genomic factors relating to growth factors, thyroid and sugar metabolism. Once identified each of these factors can be addressed.

Understanding the problem: Currently, the rate of treatment response to first-line treatment for anxiety with SSRIs is moderate, varying typically from 40 to 70 percent and remission rates range from 30 to 50 percent. Many individuals being treated will develop recurrent symptoms of anxiety (or co-morbid depression) while on therapy. Understanding what genetic variants contribute to anxiety risk allows clinicians to consider a precision medicine, genomically targeted approach.  This approach also allows clinicians to identify which adjunct treatments (published specific nutritional interventions, light therapy, supplements, vitamins as well as T3 or specific dietary changes) might be best able to help any one individual and improve remission and response rates. Case studies will be used for illustration purposes.