Stating that personalized drug treatment was given to a psychiatric patient who did not improve despite using medication for a certain period of time, Psychiatrist Prof. Dr. Nevzat Tarhan said that the biggest difficulty of psychiatric patients is not being understood by the patients.
“With high-tech imaging devices, we see with concrete, biological evidence that the brain that thinks, feels and decides does not work properly,” said Prof. Dr. Tarhan noted that they benefit from all the advantages of artificial intelligence for personalized treatment. Tarhan said, “With artificial intelligence, medical errors will decrease, we will collect important data, and we will have the opportunity to catch many things we missed.”
Psychiatrist Prof. Dr. Nevzat Tarhan, Founding Rector of Üsküdar University, noted that personalized treatment has existed in medicine for a long time, but combining it with systematized information is new and continued his words as follows:
“The concept of personalized treatment was brought to the agenda with former US President Barack Obama. Instead of giving the same medicine to everyone, Obama launched a serious project to provide personalized treatment according to the person’s genetic structure and brain function. I can summarize the purpose of this program, called the Brain Initiative project, which is aimed at conducting brain research with Advanced Innovative Neurotechnology, as helping the treatment of brain-related diseases. We collaborate at a global level with the Society for Brain Mapping and Therapeutics (SBMT), in partnership with Üsküdar University and NPİSTANBUL Hospital. This year, as every year, we were the only university representing our country at the G20 – Neuroscience20 (BRAIN-SPINE-MENTAL-HEALTH) conference in India. Again, on 03-08 September 2023, we hosted the 6th BaCI (Basic Clinical and Multimodal Imaging) Conference, which was held with the participation of 60 international researchers from 12 different countries. At the conference, we discussed the latest developments in the fields of neuroscience, genetics and medicine. “We support all kinds of initiatives and continue to organize scientific organizations to discover unknown aspects of the brain and shape the future of neuroscience.”
“The critical concept is the best interest of the patient”
Tarhan said, “In the military, it is said, ‘The commander is responsible not only for the work done, but also for the work not done.’ Both a doctor and a healthcare professional should be like this. He should be responsible not only for the treatments he gave, but also for the treatments he did not do. One of the types of harm to the patient is to leave the patient without treatment. If a method has come to the fore somewhere in the world, we have to follow it and apply it when necessary. If you say, “I only know this, I can apply this,” you will only be an expert who looks at the situation from your own perspective. The critical concept is the patient’s best interest. “For the best benefit of the patient, it is necessary to benefit from all kinds of science, traditional and modern methods.” He also warned.
Personalized medicine era
Prof. said that there were two serious revolutions in the world after the 2000s. Dr. Nevzat Tarhan stated the following: “One of these is the genetic revolution, the second is the neuroscience revolution as of 2018. In the genetic revolution, the gene map was created. The human genome is now known. DNA is taken from a person, that DNA is sequenced, it is compared to the common gene in the genome map, and medication is given according to that person’s genetic profile. DNA analysis is performed to check the suitability of the drug for the patient and the rate of metabolism. The liver is truly an amazing laboratory. When we look at which gene works and how it works, if we give that drug to that person if he metabolizes it quickly, it will be wasted. In developed countries, especially in the West, if they give epilepsy drugs that require genetic testing and the patient develops an allergy, the doctor becomes responsible. This drug has such a risk, there are doctors who pay compensation if they prescribe it without analysis.”
“The maximum form of treatment is personalized treatment”
Informing on the application stages of the treatment, Tarhan said, “If the disease has just started and does not respond to minimum treatment, optimum treatment is applied. If he does not respond to that, maximum treatment, that is, personalized treatment, is put into effect. Action is taken according to the standards of treatment. For example, if there is no improvement despite using medication within 6 months, personalized medication is administered. The method of giving medication according to DNA is now a great convenience in conscious cases. We have greatly reduced the number of patients who are conscious in our field going abroad. Türkiye has made very serious groundbreaking initiatives in the field of health. We tried to do this in our own field, and we are still working.”
“The biggest challenge of psychiatric patients is not being able to understand the patients”
Prof. Dr. Nevzat Tarhan stated that the biggest difficulty of psychiatric patients is that they cannot be understood and continued as follows:
“The patient is in pain and suffering, and you see that everyone is advising you, ‘Don’t worry about it, it’ll get better, be your own doctor.’ This person comes to us. We look at the person’s brain functions with personalized treatment methods. We see that there is a war in that person’s brain. The signal flow in the brain is impaired, the energy flow is impaired, and substances such as serotonin and dopamine are reduced. The thinking brain, the feeling brain, the decision-making brain are not working properly, there is concrete biological evidence. When I show this, patients start crying. Even spouses bring the patient with good intentions. Some patients say, “Didn’t I tell you that I am this sick?” he says to his wife.
When shown the treatment plan, if the patient believes in the disease and the treatment, the brain secretes 40% healing chemicals, said Prof. Dr. Nevzat Tarhan; “The brain is activated. There is also its opposite. It is called the ‘nocebo effect’. If a person believes in his illness even though he is not sick and says ‘I have this disease!’, it happens. For example; If he says ‘I’m going to feel dizzy’, his head starts to shake. In such a situation, the brain takes a position regarding the existence of the disease, makes perceptions and produces chemicals. For this reason, the brain needs to be taken into consideration even in internal diseases in order to provide personalized treatment.”
Artificial intelligence will reduce medical errors
Psychiatrist Prof. Dr. Nevzat Tarhan, Founding Rector of Üsküdar University, emphasized that the third important pillar of personalized treatment is the use of deep learning and artificial intelligence and continued his words as follows:
“Artificial intelligence will also reduce medical errors. It will support the physician in making decisions if he is faced with complex situations. In this way, medical damages will be minimized and will provide a significant advantage. We doctors will collect important data. Radiology has become the field that uses artificial intelligence best. For example, we currently use the artificial intelligence and deep learning based MRI device. The patent belongs to us. This device can give a preliminary diagnosis to the specialist so that he does not miss anything. He then confirms or falsifies it. By performing brain imaging with artificial intelligence, we will provide the opportunity to catch many things we missed.”
