Thursday, September 13, 2012

Pharmacologicae

At present, no medication has received approval from the United States Food and Drug Administration (FDA) for the treatment of any neuropsychiatric consequence of TBI. The lack of FDA approved treatments in this population is, in the opinion of the authors, a reflection of medicoeconomic issues rather than of the science relevant to the development of such treatments.
So says the NIH, in a report that is the subject of this post.

If there were a magic pill I would gladly take it and disappear into my life. Fold up this blog (fun though it is). Quit going to Hacker Dojo, where the sign says "Unattended Children will be given to the Goblin King". Or, perhaps be hypnotized by the enormous sculpture of red, yellow, and blue foam noodles hanging from the ceiling...

A lot of pills for other things can also lend a hand with recovery from TBI. What's missing are the official guidelines on how to use them. Up in Canada the medical establishment comes out and says that.

(This is a useful, balanced summary, by the way, if you're researching pharmacological options. The only big hole I could see is recent discoveries concerning progesterone.)

So, depending on your perspective there's either no magic to be had, or nothing but magic to be had. On the no-magic side, you aren't gonna go to an MD (even over a period of time) and come out better. Not gonna happen.

On the all-magic side, the lack of FDA guidelines means that doctors can prescribe whatever the heck they think will help. Literally! They don't have to justify why or what, or how they followed up. Get out the magic wand. Or shotgun. Or whatever metaphor you prefer.

Here in the pill-happy US you would think this expressive freedom works in doctors' favor. But they seem pretty ambivalent about charting their own paths. Not because they're reluctant to use me as a guinea pig - if they are I never noticed. No, it seems to be more self-protective, whether they're quick or reluctant with the pills.

Dr. H didn't prescribe anything at all for 2 years, when I showed up with light and time-shifting issues. Then he suggested Ambien (no thank you). Dr. M. told me to stop doing so much exercise, especially yoga. (No words on caffeine, the actual source of my agitation.) Dr. A., of course, was ready to put me on an SSRI. Only Dr. H. had anything like the multidisciplinary, collaborative approach this paper recommends.

It all amounts to something like a religion among practitioners. You never really know what's going to come out of their mouth and when, revealing their personal strategy and beliefs. I just hate those moments, when the snake slithers out of their mouth. Those are the times I almost wish I were uninsured, so I wouldn't have to sit there and listen. I'm not that into someone else's religion, when it comes to science.

Here's my own pharmacologicae:
  • Caffeine
  • Aspirin (helps with amnesia-like memory gaps, probably caused by caffeine)
  • Omega 3, 6, and 9 fatty acids
  • Melatonin
The goal is to use all of the above while regenerating neurons, via strenuous exercise. Neurogenesis. That's my science. Or religion. Whatever.

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