Outcomes

The essential innovation to the purine-based approach is overlaying symptoms and treatments onto a purine metabolism map. The purine metabolism enzymes then create a geography suggesting how imbalances can be sequentially resolved to return the patient to a state of reliable mental health.

As treatments shift imbalances from one location to another, we see symptoms shifting along the purine metabolism map. These intermediate changes in presentation, following the geography of the overlayed map of provides supporting evidence.

Medications are typically used in combination, but the data describing specific combinations of medications is extraordinarily sparse. Having the variety of medications mapped on a single chart can help providers identify contradictory or counter-productive effects of medications to identify dramatically simplified regimens: e.g. a psychotic patient transitioning from compulsory treatment with 2 mood stabilizers and 3 high-dose antipsychotics to long-term voluntary stabilization without psychosis on a maintenance regimen of a single subtherapeutic antipsychotic with mild augmentation agents. 

About 30% of patients will be considered treatment-resistant: to a non-targeted series of trials. Identifying apparent imbalances can lead to expanding the differential diagnosis and/or identify more targeted treatments.

There are a variety of medications and dietary supplements that can have therapeutic effects when used in particular imbalance states. Using chemical structure, rather than artificially constructed drug classes, to identify a wide variety of treatment agents allows for broader possibilities and may help limit treatment risks.

Several diagnoses are identified as having no clearly recommended treatments: e.g. dementia. Mapping these disorders onto purine metabolism allows for new combinations of existing treatments to effectively address symptoms. For example, a patient with early Alzheimer's and CT findings concerning for vascular dementia progressed from non-verbal, not toileting to able to communicate musical preferences and manage ADLs with minimal prompting.