Embedded Files
Research is typically done on single agents, but in practice, medications are most often used in combination. This Clinical Guide offers a way to model/ predict the effects of medication combinations.
Research typically doesn't proceed once agents are FDA approved, especially not once the patent expires: unfortunately, this is the time that the medication's use should be undergoing the most refinement. Which symptoms does this most directly affect? Who is the ideal candidate? How will this medication affect other symptoms?
Although the theory is complex and supported by hundreds of citations from the medical literature, the practical question is how to treat a patient's symptoms. This document links symptoms to apparent purine imbalances and medications that may tend to alleviate (or exacerbate) those imbalances.
Purines are noted in greyscale, symptoms in italics, with symptomatic excesses in bold, deficits in plain italics. Lines/arrows represent purine metabolism enzymes that seem to be activated or inhibited by various listed medications, based on a combination of chemical structure and clinical experience.
The names of the enzymes are understated in this chart to provide maximum attention to symptoms and treatment. There are some purines available as dietary supplements, including SAM-e (SAM), Inosine (Io), and NAD. SAM-e has literature support for psychiatric clinical use.
These charts have helped me to more accurately predict response to complicated combinations of medicines and symptoms. I have been able to watch in detail as symptoms are transformed, then resolved.
clinical guide 1.20.26.pdfMy hope is that providers can join me in using this theory as an additional way to formulate symptoms and treatment. Agents noted as unnecessarily opposing each other may be able to be streamlined. Specific agents within current accepted clinical practice may be prioritized in order to more precisely target and treat symptoms. Where traditional recommendations have been exhausted, similarities in chemical structure or apparent effect may point to off-label options.
There are multiple rationales that can be put forward for taking the next steps: notes can include isolated medically-acceptable reasons rather than propounding the purine theory of psychiatry.
In many cases, there are symptoms of excess that could be targeted to resolve both an excess and deficit at the same time. These steps should be prioritized if possible.
Page updated
Google Sites
Report abuse