Pharmacogenomics is where this report is most actionable, and most of the flags came back negative. That is the honest headline. Flags differ by border and label, not by color.
| Drug or compound | Predicted response | Flag | Driving SNP |
|---|---|---|---|
| TB006 anti-galectin-3 antibody | Predicted non-responder | Non-responder | LGALS3 ×2, homozygous |
| SSRIs | Non-responder flag | Non-responder | COMT V158M (2) |
| SSRIs and 5-HTP | Avoid — less likely to respond, may worsen symptoms | Caution | HTR1B |
| Methylphenidate | Reduced response | Reduced | COMT V158M (2), NTF3 (2), SLC6A2, DRD3, DRD4 |
| Bupropion | Reduced response; reduced smoking-cessation success | Reduced | COMT V158M (2), CYP2B6 AG |
| Atomoxetine | Less likely to respond | Reduced | DBH T15791C |
| Opioids | Non-responder for analgesia; elevated addiction and severe-outcome risk | Non-responder | OPRMI GG (2), TH AA (2) |
| Folate (for homocysteine) | No significant homocysteine reduction | Non-responder | BHMT R239Q (2) |
| Donepezil, rivastigmine, huperzine | Possible non-response; long-term use may worsen memory | Caution | BCHE |
| Propofol | ~20% less needed; falls asleep ~40% faster | Reduced | HTR2A AA (2), 18.6% prevalence |
| Succinylcholine-family anesthesia | Difficulty waking | Caution | BCHE CT |
| Methamphetamine-containing stimulants | Avoid | Caution | OPRMI GG (2) |
| Quercetin | Caution with two copies of COMT | Caution | COMT V158M (2) |
| THC (CYP2C9-metabolized) | Slow metabolizer — reduce dose | Caution | CYP2C9 CT |
| CBD | Increased anxiety and psychosis risk — start low | Caution | FAAH AG |
| Interferon | Non-response warning | Non-responder | CARD8 |
| t-PA | Pharmacogenomic warning printed | Caution | A2M |
Approximately 20% less propofol needed, asleep roughly 40% faster. High impact, 18.6% prevalence.
The action plan turns that into a standing instruction. This is the most immediately usable line on the ledger.
Difficulty waking from succinylcholine-family anesthesia. Additive interaction with APOE e4 that the report links to sudden worsening of cognition with deep anesthesia, more significant over age 65.
Two-copy carriers may not respond to acetylcholinesterase inhibitors prescribed for memory problems — donepezil, rivastigmine, and the supplement huperzine — which may with long-term use even make memory worse.
Two separate SNPs, both high impact, both homozygous. The clinician summary escalates to a printed all-caps callout: two copies of this SNP makes me a predicted non-responder to TB006 anti-galectin-3 antibody treatment based on initial research.
Other modalities should be considered. That belongs here and not as a confidence tag I invented.
HTR2A AA, two copies, high impact, 18.6% prevalence: approximately 20% less propofol needed, asleep roughly 40% faster. That is a concrete, immediately usable, non-hypothetical action.
The rest of the negative flags stay on this table. I did not turn them into a second protocol.
Predicted drug response is not blood flow and not rhythm. Omitted: any AGREES claim.
How it works is the primer. The library is the index. The other spokes are the payload.
The two doctors’ pages still hold the moving pictures.