After going to the Dentist yesterday morning, I went to see my psychiatrist.  Mostly we talked about my meds – I am still struggling too much of the time.

I am adjusting the timing of one of my meds for a couple of weeks to see if that helps.  After that we may alter the form of my med – I could try the Extended Release version.  Then things get more complex.

There is a new kind of Liver test that shows how your liver deals with different kinds of chemicals.  The test shows the efficiency of 6 different pathways thru the liver, that can determine how some drugs are metabolized.

Primarily, the 2D6, and 2C19 pathways are most involved in metabolizing psychoactive meds.  My 2D6 may be too efficient.  That would explain why I need twice the maximum recommended dose of one med, and why that is not enough.  My liver may be eliminating it before it can do its job.

If may also show why Vicodin did not work very well for me.

The down side… the test is about $1000, and it is classified as “Experimental”.  So insurance will not cover it… but I may have no other way to go.  I can’t just keep trying me meds, and combinations.