Mood disorders, such as anxiety and depression, are quite common in people with chromosome 18 conditions, particularly as they enter the teenage years. Many families have struggled to find the right medication and dosage to treat these concerns. We at the Chromosome 18 Clinical Research Center are frequently asked, "Do any meds seem to work better for children with C18 conditions?" Of course, this is a very reasonable question to ask. After all, if two people's anxiety is related to the same underlying genetic condition, shouldn't they both react similarly to specific medications?

Unfortunately, at this time, there is no silver bullet when it comes to treating these conditions. This is for a few different reasons. First, conditions such as anxiety and depression are multifactorial. That means that they are caused by a combination of both genetic and environmental factors. A deletion or duplication on chromosome 18 is just one of those factors. We know that there are other genes on other chromosomes that may also contribute to a person's psychiatric well-being. In addition, environment also plays a large role. This means that events at home or school may also contribute to someone's depression or anxiety. Therefore, different people with a chromosome 18 condition might have different factors contributing to their depression or anxiety.

In addition, non-chromosome 18 genes influence how a person reacts to medication. Genes help determine how a person metabolizes drugs. Some people metabolize certain drugs differently than others. This may cause some drugs to be less effective for some patients. Different genes may also make some patients more prone to various side effects.

Lastly, other risk factors may guide medication decisions. For example, if a person has elevated risk for a medical condition, such as bone loss or dystonia, a physician may weigh potential side effects differently when choosing a medication.

The complex interactions of genes, environment, and medication are not well-understood right now. Therefore, determining the correct type and dosage of medication is both a science and an art. Once it has been decided to start a new medication, there is often a trial and error period while the physician and family work together to find the right answer for the family.

Of course, we will continue to collect data on the medications used by our study families.  Meanwhile, other researchers research gene-drug interactions. This is yet another example of how other types of genetic research will someday provide information for our families.