Solving Psychiatry

Psychiatric suffering cries out for understanding: state of the art management predicts an effective treatment in a meager 30% of cases: another third will respond to a later trial and the last third will remain treatment resistant in both psychosis and depression. 

In an attempt to clarify, psychiatry has subdivided diagnoses (schizoaffective disorder vs. schizophrenia, schizophrenia subtypes) and medications (first or second generation, SSRI vs. SNRI), but neither has proved helpful. New treatments are often represented as being part of a new drug class, further fragmenting the psychotropic landscape.

In contrast, symptoms and treatment responses are clearly connected. Like a Rubik's cube, bluntly solving one side can create problems on another side (changing mania into depression or psychosis into metabolic syndrome). 

What if we could understand medications in the way that the body understands them? What if we could see natural compounds that medications mimic and therefore be better able to predict tolerability and response, including among drug combinations?

When suffering is not understood, listening, learning, gentle kindness and being willing to be with the suffering peer may be all we can give. Parallel to these efforts should also be a drive to rethink in an effort to find a better understanding.

This site suggests a new way to approach mental illness, developed by clinical necessity, to work with available medications and dietary supplements to better predict treatment response and reduce suffering. A revolutionary theory will require decades of clinical research to be fully investigated: is there something you can do now to address suffering?

Rather than considering receptors or neuronal reuptake, this new theory considers purine imbalance to be the chemical imbalance of common parlance and aims to address them.

Purine metabolism changes one purine to another via complicated cyclical pathways with multiple rate-limiting steps, susceptible to a variety of logjams. In the brain, purine metabolism enzymes are spread out among multiple cell types requiring coordination and balance to perform basic cell functions. Relative concentrations of different purines control effects.

Disrupted purine metabolism is present in a variety of psychiatric disorders including bipolar, depression, psychosis/ schizophrenia, substance use, autism, and dementia. Some proposed psychiatric treatments target purine metabolism: others have later been shown to strongly affect purine metabolism.

Although purine profile testing is not available, certain psychiatric and physical symptoms correlate with specific purines. These can be used to formulate an individualized purine metabolism disruption hypothesis, which can be matched with purine-mimic treatments to create a treatment plan that holistically targets both psychiatric and physical symptoms, including chronic medical disorders. Commercially available genetic testing may also identify purine metabolism enzyme variation.

Targeting apparent purine imbalances can simultaneously treat psychiatric and physical symptoms and gradually decrease the need for psychiatric intervention, restoring robust psychiatric and physical health.

With a purine framework, treatment experience (effects and side-effects) can do more than simply include or exclude one agent: it can refine the working hypothesis, provide potential explanations for treatment resistance, and guide selection of the next agent. 

Very few medical disorders/ symptoms are currently attributed to purine imbalances. But purines are evolutionarily ancient and therefore ubiquitous. Psychiatric medications can have a broad range of side-effects, including endocrine (hormone) and immune-system changes. Purine-related disorders may be similarly broad. Understanding purine metabolism may provide guidance for a variety of clinical problems.