Monday, September 30, 2019

Reading the Research: Predicting the Medication Roulette

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article is a step in the right direction when it comes to prescribing pharmaceutical depression treatments.  Many autistic people suffer from depression, myself included.  In fact, when I was first diagnosed, it was recommended to me that I go to the doctor and get a prescription for an SSRI (Selective Seratonin Reuptake Inhibitor: the most common antidepressant type).  "To take the edge off", they said.  

Because I'm occasionally a prideful and stubborn human, and I was already aware of what I call the SSRI Russian Roulette Game, I ignored this advice and opted to not get help with my depression.  Later, after failing out of a couple jobs, I found my way to Dr. Nicole's office.  Under her care, a combination of supplements, exercise, neurofeedback, and improved mental/emotional management have reduced my depression and anxiety to the point where medication would be redundant.

Most people don't ignore this advice to get help, especially if their depression is severe.  The problem is that you never know which SSRI is going to help, and there are dozens, if not hundreds.  Finding the right one can take literal years, and that's assuming there is a right one (some forms of depression aren't helped by SSRIs).  In the meantime, you try one every 2-3 months (because that's how long it takes to figure out if one's working), and hope the side effects aren't too onerous.  Weight gain, sexual dysfunction, insomnia, nausea, headaches, and dizziness are all possible options when using SSRIs.  

All this to say that the way we figure out how to help people is, um... extremely suboptimal.  That status may be a thing of the past soon, though!  These researchers say they've been able to use brain scans to predict whether SSRIs in general will help a given person.  If this technology proves to work, it could cut years out of the treatment process.  I could see such technology and algorithms predicting responses to specific SSRIs, and even other classes of anti-depressants.  I really hope so.  Depression and anxiety are very common problems even outside the autism community.

(Pst! If you like seeing the latest autism-relevant research, visit my Twitter, which has links and brief comments on studies that were interesting, but didn't get a whole Reading the Research article about them.)

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