Meds Compliance: An Addendum

John McManamy Health Guide
  • Someone close to me - let's call him Cortex -  had a brain which literally broke down on him. Poof! Up in a puff of smoke, just like that. It was as if his gray matter imploded, just like you see on The Discovery Channel with doomed Vegas hotels that have outlived their purpose. One minute, a standing structure. The next, a cloud of dust.

    Only there were no cheering crowds.

    "Depression," could not possibly do justice to what happened to the brain of Cortex, but the DSM does not list anything under "implosion." Nor is there a clinical condition to describe "lifeless, clinically dead but still breathing." Depression would have to do. The same word they use on people feeling sad or drained or overwhelmed or having a spiritual crisis.

    Add This Infographic to Your Website or Blog With This Code:

    So they treated him for depression. He was prescribed antidepressants, plus the occasional antipsychotic for when his reality went AWOL. Plus stuff to help him sleep, not that he needed an assist there, being clinically dead and all. Nothing worked. He got a little bit better. Then he got worse.

    Months went by. Then more months. There was only one option left. ECT. He was admitted to the hospital. They knocked him out and attached the jumper cables. He woke up disoriented and confused. But with a spark of life. More treatments. The lights came on. His brain booted up. He got his brain back. His thoughts, feelings, perceptions.

    You looked into his eyes and saw life, a soul, humanity. He was engaged, fully engaged. This wasn't just a recovery. This was a miracle. A resurrection.

    So, here's what I'm thinking. It looks like there will be a happy ending for Cortex. We still have to keep our fingers crossed, as relapses do happen. But it's reasonable to assume something went right, really right.

    But what, precisely, went right?

    It probably wouldn't be hard to figure it out. Not everyone responds to ECT. Cortex obviously did. Some people respond to meds. Cortex obviously didn't. The trouble right now is we have no way of knowing in advance how people like Cortex will respond. Or do we?

    Suppose they drew a blood sample from Cortex and did a complete gene scan. Suppose they also did a brain scan. Suppose they did this with hundreds of others like Cortex, people who responded to ECT. Or, looking at it another way, people who did not respond to meds.

    Suppose they compared Cortex's scans to others like himself. Suppose they found some gene variations in common or some structural brain quirks. Suppose they were able to build a huge database. Suppose, based on this, clinicians could identify in advance who was likely to respond to certain treatments and who was not. The technology is there, the funding isn't.

    Cortex will be reintegrated back into the world, a success story, but with none of us any wiser. So it is that someone else - someone like Cortex - will walk in the door, a nonresponder to meds, a responder to ECT. And the doctor, operating in the dark, will start him on meds.

    Frustrating, isn't it?  

Published On: October 22, 2010