The problem with many psychiatric medications is that they stop working after a period of time. This happens most often with anti-depressants and anti-convulsants and is often referred to as “poop out” (seriously).

A more scientific term is tolerance. When you have developed a tolerance for a medication, you either need a higher dose of your current med or you need to switch to another med to produce the desired effect. It does not necessarily mean you are addicted—that’s another class of drugs.

There are two more ways to circumvent the med that’s not working anymore, try a med in the same class or try taking some time off the med. Research has shown that meds can be effective again after you’ve been off of it for a period.

The difficulty  with the solutions is that you are in the lurch and symptomatic while trying to figure out the best next step. This can be an extremely frustrating process.

A potential answer is gene site testing. By taking an oral swab or some blood, tests can be performed that show how your genes affect your response to medication.

Gene site testing, also called pharmacogenomic testing, determines whether a medication could be an effective treatment for you;

the best dose of the medication; and whether you could experience serious side effects.

Unfortunately, the test only measures one medication at a time. The tests also aren’t available for some meds.

Both my brother and my son have undergone gene site testing and it was very helpful to them. My brother learned which medications he metabolizes well and my son learned that Prozac was a good match for him.

I was very lucky with Prozac in that it lasted 12 years before it didn’t work anymore. I was then off of it for 15 years and am now taking it again with good results. I have also developed a tolerance to Provigil and Nuvigil, “mood brightening” agents.

I have not participated in gene site testing, but I’m very glad this tool is available. I have tried over 20 medications since I began this journey and I am grateful that there is now a test to determine if a medication will work rather than just having to try the med, wait weeks and either have side effects or the med doesn’t work.

Although you can develop a tolerance to a medication, you do have options.  Take an increased dose to get the same results, try a different medication and, when available, gene site testing.

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SOURCES:

http://www.healthyplace.com/blogs/breakingbipolar/2012/05. Tolerance-when-psychiatric-drugs-stop-working.

Mayoresearch.mayo.edu/center-for-individualized-medicine/drug-gene-testing

5 Comments on Medication Tolerance, yup…it’s a thing

  1. I’ve never even heard of gene site testing before, but it’s a good resource to know about if I were to ever choose to do it! I’ve definitely heard of medication tolerance, such an annoying thing!

    • I remember when it hit me that I could develop a tolerance to any of my meds and that they wouldn’t work any more–Yikes! What have you developed a tolerance to?

      The problem, for me, with gene site testing is the cost. Sometimes insurance will cover it and sometimes it won’t. My insurance only partially covered the procedure when my son had it done. I don’t think his doctor would have ordered the test had he known that insurance wasn’t going to fully cover it.

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