How I Practice

How I Practice: DO’s company brings genetic testing to psychiatry

Jay Lombard, DO, co-founded Genomind, which offers genetic testing that helps physicians tailor treatment for mental illness.


You’ve been diagnosed with depression, so your psychiatrist recommends you get a genetic test. Based on the results, she designs a treatment regimen that’s tailored to you, using insights about your genetic markers to select the medication that’s most likely to be effective.

That’s the premise behind Genomind, a company co-founded by Jay Lombard, DO, a board-certified neurologist. In this edited conversation, Dr. Lombard explains how Genomind came to be and why biological data should be a critical element of psychiatric treatment.

What was the inspiration for Genomind?

I’ve always been intrigued by the intersection of neurology and psychiatry. When I was chief of neurology at Bronx Lebanon Hospital, I would tell my psychiatry residents that their understanding of every pathway and neurochemical in the brain needed to be as precise as if they were performing neurosurgery.

Jay Lombard, DO

Research on the human genome has yielded data that could allow us to look at a psychiatric diagnosis and find the genes associated with that disease, but no one was translating those findings into a clinically useful tool. That was the genesis for Genomind. Physicians can contact us to request testing for patients. Using a cheek swab test, we analyze the patient’s genetic data and create a report which the clinician uses to develop a treatment plan that’s designed uniquely for that patient.

One scenario we see frequently is a physician treating a patient who’s taken multiple medications without success. Genetic testing gives insight into which medications are likely to work for a particular patient, which medications aren’t, and which may cause adverse effects. The test analyzes 18 genes that have been shown in peer-reviewed studies to impact psychiatric treatment. For physicians and patients, seeing those test results is often an “Aha!” moment as far as understanding why a previous medication wasn’t effective.

What’s the role of data in treating psychiatric disease?

Biological data is just as important in treating psychiatric illness as it is in treating other types of disease. When someone falls ill with cancer, the oncologist often knows which mutations are driving the illness and deploys a chemotherapeutic drug that targets those mutations. We’re very specific in understanding the biology of cancer; why are we not doing that in brain disorders?

Genetic testing can help provide some of the specificity that has been lacking in psychiatry up until now. Mental illness is often diagnosed based on a checklist of symptoms, even though physicians would never dream of relying on a checklist to diagnose diabetes or heart disease. By analyzing patients’ genetic markers, physicians can arrive at a more complete understanding of what’s going on in the brain.

Where do you think this field will be in 10 years?

I think all data will be considered fair game. You’ll go to your neurologist of the future and plug in your medical history, family history, genetic data, lab imaging, glucose and cholesterol levels, the medications you’re taking—all these seemingly disparate elements of information about the human brain that we can quantify. All that will be put into an informatics source where it will converge and be analyzed to find out what’s meaningful. Your doctor will have that information at the push of a finger.

The use of biomarkers in psychiatric treatment is on a similar arc to cellphone technology. In the 1980s, cellphones were these 5-pound bricks, but the technology has evolved incredibly rapidly since then. That’s the beauty of this field—it’s an iterative process.


  1. Jim Powers

    While I believe there is promise in the use of this testing to help improve the treatment we provide to our patients, I believe most patients are unaware of the financial cost of this testing. A co-worker of mine went to a psychiatry practice to be evaluated for depression. She was offered the testing and was told the maximum cost to her would be $325.00 and when she agreed, they had her sign a financial consent for for the testing. A few weeks later she received a bill for $6,090. Her insurance refused to pay for it and she has a high deductible insurance plan with a $5,000 deductible. In the fine print of the paperwork it stated the patient’s responsibility would be a maximum of $325, unless they had not met their health plan deductible and then their responsibility would be up to their full deductible. So they are now asking for a payment of $5,000. In my opinion, this is irresponsible and not in the spirit of informed consent or cooperative decision making. She then related that even if her insurance would have covered the entire cost, she would have never agreed to a $6,000 test for her symptoms. So while there may be some utility in these tests, I believe there should also be full disclosure regarding the limitations and costs of this testing. Perhaps her provider didn’t even know the cost or the ultimate financial burden it caused this patient.

    1. Melissa Smith

      Sorry to hear of your friend’s experience. I assure you that the testing that your friend had done at her psychiatrist’s office was not a Genomind test but a different company called Assurex who offers the Genesight test. The $6,090 is what was billed to her insurance company and is only the amount on her EOB not her bill from the company that completed her test. Patients often receive EOBs thinking that they are bills but they clearly state somewhere “this is not a bill.”

      Genomind also has a different billing policy than the company that your friend used and it is very affordable.

  2. Tim Talleywhacker MD

    I have long advocated testing brain chemicals especially neurotransmitters to check the balance in normal versus symptomatic patients.
    This test approaches it differently and may be more accurate.
    I agree with the first comment that the cost is outrageous. I think partly because all testing and imaging now wants to get a direct IV into the money vein of all insurance companies. This means any private pay patient is out of luck.

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