The GeneSight Psychotropic test covers roughly 60 psychiatric medications across six categories: antidepressants, antipsychotics, mood stabilizers, stimulants and non-stimulants for ADHD, anxiolytics and hypnotics, and medications for tardive dyskinesia. It uses a cheek swab to analyze your DNA, then generates a color-coded report showing how your body is likely to process each drug.
Antidepressants on the Panel
The test includes 22 antidepressants spanning several drug classes. SSRIs make up a large portion: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). SNRIs are also covered, including desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
Beyond those two common classes, the panel covers older tricyclic antidepressants like amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), and nortriptyline (Pamelor). It also includes bupropion (Wellbutrin), mirtazapine (Remeron), trazodone (Desyrel), selegiline (Emsam), vilazodone (Viibryd), and vortioxetine (Trintellix).
Antipsychotics on the Panel
Nineteen antipsychotics are included. The newer, more commonly prescribed options on the list are aripiprazole (Abilify), brexpiprazole (Rexulti), cariprazine (Vraylar), clozapine (Clozaril), lumateperone (Caplyta), lurasidone (Latuda), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Older antipsychotics like haloperidol (Haldol), chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), thioridazine (Mellaril), and thiothixene (Navane) are also covered, along with asenapine (Saphris) and iloperidone (Fanapt).
Mood Stabilizers
Seven mood stabilizers appear on the report: carbamazepine (Tegretol), gabapentin (Neurontin), lamotrigine (Lamictal), lithium (Eskalith), oxcarbazepine (Trileptal), topiramate (Topamax), and valproic acid/divalproex (Depakote). Several of these are also prescribed as anticonvulsants, so the results can be relevant if you take them for seizure disorders as well.
ADHD Medications
The panel covers both stimulant and non-stimulant ADHD treatments. On the stimulant side, it analyzes how your genetics may affect your response to methylphenidate and dexmethylphenidate. People with a specific variant in the gene that encodes a key norepinephrine receptor (ADRA2A) may have a reduced response to these stimulants.
For non-stimulants, the test provides particularly detailed information about atomoxetine (Strattera). If your body breaks down this drug much more slowly than average, you’re more likely to experience side effects, but you may also see greater improvement in ADHD symptoms. The test flags this tradeoff so your prescriber can adjust the dose accordingly.
What Genes the Test Analyzes
GeneSight looks at 14 genes, split into two functional groups. Nine genes affect how your body breaks down medications. These are primarily liver enzymes in the CYP450 family: CYP2D6, CYP2C19, CYP1A2, CYP2B6, CYP2C9, CYP3A4, along with CES1A1, UGT1A4, and UGT2B15. Variations in these genes can make you metabolize certain drugs faster or slower than average, which directly affects whether a standard dose will be too weak, about right, or likely to cause side effects.
Five additional genes influence how medications work once they reach their target in the brain. SLC6A4, for example, relates to serotonin transport and can affect how well SSRIs work for you. HTR2A involves a serotonin receptor. ADRA2A relates to norepinephrine signaling and stimulant response. Two HLA genes (HLA-A*3101 and HLA-B*1502) flag the risk of serious allergic reactions to certain mood stabilizers, particularly carbamazepine.
How to Read the Results
The report sorts each medication into one of three color-coded categories. Green (“use as directed”) means your genetic profile shows no significant interactions with that drug, so standard prescribing guidelines apply. Yellow (“moderate gene-drug interaction”) means your genes may affect how you process or respond to the medication, and your prescriber might want to consider dosage adjustments or closer monitoring. Red (“significant gene-drug interaction”) means your genetic makeup substantially alters how you metabolize or respond to the drug, and alternatives or significant dose changes are worth discussing.
The report does not tell you which medication to take. It narrows the field by highlighting which drugs are more or less likely to work well given your genetics. Your prescriber still factors in your symptoms, medical history, other medications, and preferences.
Who the Test Is Designed For
GeneSight is commonly ordered for people with depression, anxiety, ADHD, and other psychiatric conditions. It tends to be most useful if you’ve already tried one or more medications without adequate relief, experienced significant side effects, or have a complicated medication regimen where drug interactions are a concern. A meta-analysis of clinical trials found that patients whose treatment was guided by GeneSight results were 41% more likely to achieve remission from depression and 30% more likely to respond to treatment compared to patients receiving standard care.
Insurance and Cost
Coverage varies widely by insurer and plan. Some Medicare plans cover the test, though several large insurers still classify it as investigational. Medicaid and commercial insurance coverage is inconsistent, with many plans not covering it at all. If you’re considering the test, contact both GeneSight and your insurance company beforehand to get a clear picture of your out-of-pocket cost. GeneSight does offer a financial assistance program for patients who qualify.
What the Test Does Not Cover
The GeneSight Psychotropic panel focuses on psychiatric medications. It does not cover most drugs used outside of mental health treatment, including blood pressure medications, diabetes drugs, or general antibiotics. It also won’t predict your response to therapy, lifestyle changes, or non-pharmacological treatments. And while it tests for genetic factors, genetics is only one piece of how you respond to a medication. Factors like diet, other drugs you take, kidney and liver health, and even your gut microbiome all play a role that the test cannot capture.