Pharmacogenetic Testing
Genetic Testing for Psychiatric Medication in Maryland, Ordered When It Will Change Your Plan
Dr. Hardik Yadav, MD
Board-Certified Psychiatrist · Addiction Medicine (ABPM) · Maryland
Medically reviewed by Dr. Hardik Yadav, MD, Board-Certified Psychiatrist licensed in Maryland | 15+ Years Experience | Last Updated: July 2026
After the second or third medication that didn't work, it's fair to ask whether something about your own body is part of the reason.
What a Pharmacogenetic Panel Actually Reads
Dr. Hardik Yadav, MD, a Board-Certified Psychiatrist, can order pharmacogenetic testing as part of medication management at Ansh Health Associates, by video, for adults anywhere in Maryland. Evening and weekend times are open.
The panel looks at the enzymes your liver uses to break a medication down, chiefly CYP2D6 and CYP2C19, which between them handle a large share of the antidepressants and other psychiatric medications in common use. Your genes place you somewhere on a range for each enzyme, from poor metabolizer through normal to ultrarapid, and that position has consequences you may have already felt. If you clear a drug slowly, a standard dose can climb higher in your blood than it was meant to, which is often what sits underneath side effects that arrive fast and hard on a low dose. If you clear it quickly, that same standard dose can pass through before it does much, which is often what sits underneath a medication that seemed to do nothing at all.
What the Result Explains, and Who Makes the Prescribing Decision
A genetic result describes how your body handles a medication. That is the whole of what it describes. It doesn't name the drug that will lift your depression, and no test sold today can. The FDA has publicly cautioned patients and clinicians about genetic tests marketed as predicting how a person will respond to a specific psychiatric medication, because that link has not been established.
What the result genuinely supports is dosing, and the choice between drugs that lean on the same enzyme. That is how the published clinical guidelines use it: a poor metabolizer may call for a lower starting dose, or for a medication that depends less on the enzyme in question. Used that way, a panel answers a narrow question well.
Which makes it one input among several. Dr. Yadav reads it next to your personal and family history, what you have already taken and how your body answered, and how you score on the standard scales he uses. The prescription is his clinical decision, informed by the result rather than handed over to it.
When Genetic Testing Is Worth Ordering, and When It Changes Nothing
Testing earns its place once a medication has already fallen short. Two patterns bring most people to ask about it: a drug that did nothing at an ordinary dose, and a drug that brought on side effects fast at a small one. Metabolism is a plausible part of the story in both, and a panel can settle whether it is. Before a first medication, where the diagnosis and the history carry most of the weight, a genetic result usually changes very little.
That is the basis on which Dr. Yadav orders it: when the answer would change what he prescribes or how he doses it. When it wouldn't change anything, that's worth knowing before you pay a laboratory for it.
Why the Rest of Your Medication List Changes the Reading
A report describes the enzymes you were born with, and it has no view of anything else you are taking. That turns out to matter a great deal. Several psychiatric medications are themselves strong inhibitors of CYP2D6, paroxetine, fluoxetine, and bupropion among them, and while one of those is in your system your CYP2D6 activity can fall far enough that your body behaves like a poor metabolizer even though your report reads normal. Pharmacologists call it phenoconversion. It is well documented, the test itself can't see it, and it lifts within about a week of stopping the drug that caused it.
This is where a physician's read carries the weight. Dr. Yadav knows psychotropic medications in depth, including the places where two of them quietly pull against each other, and he reads a panel against everything else on your list. A result interpreted without that context can point confidently in the wrong direction.
From Result to Prescription, Measured at Every Visit
The panel comes back as a metabolizer status for each enzyme it covers. Read against what you have taken before and what Dr. Yadav is weighing now, it does two useful things: it can explain a medication that failed you years ago, and it can set a starting dose with a reason behind it instead of a default.
After that, the evidence is you. Dr. Yadav scores your symptoms on a standard scale, the PHQ-9 for depression, the GAD-7 for anxiety, the ASRS for ADHD, or the MDQ, and runs the same scale again at your follow-up visits, so a shift in how you feel becomes a number he can act on. A genetic result is a starting position, and your response is what confirms or corrects it. Most of his patients notice a difference within their first two to four appointments, though that varies from person to person.
The Psychiatrist Who Orders and Reads the Panel
Psychopharmacology is what patients single Dr. Yadav out for, and it is what makes a panel worth ordering at all. He is a Board-Certified Psychiatrist, and his addiction credential is Addiction Medicine, certified through the American Board of Preventive Medicine. His psychiatry residency was at the University of Louisville, and his Master's in Public Health is from the University of Texas Health Science Center at Houston. He has practiced for more than 15 years, much of it in the corrections system, treating illness that was severe and rarely came on its own.
The cases he is used to are the complicated ones: a long medication list, a history of drugs that half worked, depression with anxiety or ADHD sitting underneath it. When two conditions overlap he treats them together rather than in sequence. He sees adults across depression, bipolar disorder, anxiety, ADHD, PTSD, OCD, and alcohol and opioid use.
Testing Ordered Through Telehealth, Anywhere in Maryland
A panel is ordered the way the rest of your care runs at Ansh Health Associates, over video. Evening and weekend times are open for people whose workday has no gap in it, and no stage of treatment here asks you to come in, including ADHD medication and Suboxone. The platforms are HIPAA-compliant. Because Dr. Yadav is out-of-network, nothing is filed with an insurer, so your care stays off your insurance record and away from your employer.
What the Visits Cost, and How Out-of-Network Reimbursement Works
The visit fees are published before you book anything: $350 for the 60-minute initial evaluation and $200 for a 30-minute follow-up. Dr. Yadav does not participate in any insurance plan, so payment is made in full before the visit by credit, debit, or HSA/FSA card. Afterward you can request a superbill, an itemized receipt carrying the CPT codes and the practice Tax ID, and send it to your plan to claim whatever your out-of-network benefit pays back. What comes back depends on the plan and the carrier. The free 15-minute consultation is the place to ask what testing would involve in your case, before anything is ordered.
“A genetic panel tells me how your body handles a medication, not which one will work. I order it when the answer would change your dose or your drug, and I read it against everything else on your list.”
Dr. Yadav is a Board-Certified Psychiatrist and an Addiction Medicine Specialist (American Board of Preventive Medicine), with an MD, a Master of Public Health, and over 15 years of experience that includes complex cases in the corrections system. Every visit across Maryland is with him directly, by video.
Questions
Frequently Asked Questions
- Can a genetic test tell me which antidepressant will work for me?
- No test available today can do that, and the FDA has cautioned the public about tests marketed on that promise. What a pharmacogenetic panel shows is how quickly your body processes a medication, which guides the dose and the choice between drugs that rely on the same enzyme. Dr. Hardik Yadav, MD, weighs that alongside your history and your measured response, and the prescribing decision is his.
- What is pharmacogenetic testing?
- It is a test of the genes behind the enzymes that break medications down, chiefly CYP2D6 and CYP2C19. The result places you on a range from poor metabolizer to ultrarapid for each enzyme, which tells a psychiatrist how a standard dose is likely to behave in your body.
- Can I get pharmacogenetic testing in Maryland through telehealth?
- Yes. Dr. Yadav can order it as part of medication management for adults anywhere in Maryland, and your visits happen over video. No in-person appointment is required at any stage of care with Ansh Health Associates, including for ADHD medication and for Suboxone.
- Do I need a genetic test before I start a psychiatric medication?
- Usually not. For a first medication the diagnosis and your history do most of the work. Testing becomes useful once a medication has already fallen short, which is when it can change what Dr. Yadav prescribes or how he doses it.
- Why did a medication give me side effects at a low dose?
- One explanation is that you clear that drug slowly, so an ordinary dose reaches a higher level in your blood than intended. A pharmacogenetic panel can establish whether that is what happened. Other things can produce the same picture, including another medication you were taking at the time, which is why the result is read in context rather than on its own.
- Does Dr. Yadav order the test for every patient?
- No. He orders it when the answer would change the plan. If a panel would not alter what he prescribes for you, he will say so, and you can raise it during the free 15-minute consultation before anything is ordered.
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Disclaimer: This information is provided for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Please schedule a consultation with our team to discuss your individual needs.