Psychiatrist Prof. Dr. Nevzat Tarhan, stating that personalized drug treatment is applied to psychiatric patients who do not recover despite using medication for a certain period, said that the biggest challenge for psychiatric patients is that they are not understood. Prof. Dr. Tarhan stated that with advanced imaging devices, they see, with concrete biological evidence, that the thinking, feeling, and decision-making brain is not functioning properly, and noted that they utilize 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 find opportunities to catch many things we missed.”
Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, noting that personalized treatment has existed in medicine for a long time but its integration with systematized information is new, continued his words as follows:
“The concept of personalized treatment came to the fore with former US President Barack Obama. He launched a serious project concerning the application of personalized treatment tailored to an individual's genetic makeup and brain function, rather than giving the same medication to everyone. I can summarize the purpose of this program, called the Brain Initiative project, which aims to conduct brain research with Advanced Innovative Neurotechnology, as helping to treat brain-related diseases. With the scientific partnership of Üsküdar Üniversitesi and NPİSTANBUL Hastanesi with the Society for Brain Mapping and Therapeutics (SBMT), we are engaged in global collaborations. As every year, this year too, we were the only university representing our country at the G20 - Neuroscience20 (BRAIN- SPINE- MENTAL- HEALTH) conference in India. Also, from September 03-08, 2023, we hosted the 6th BaCI (Basic Clinical and Multimodal Imaging) Conference, which was attended by 60 international researchers from 12 different countries. At the conference, we discussed the latest developments in neuroscience, genetics, and medicine. We support all initiatives to discover the unknown aspects of the brain and shape the future of neuroscience, and we continue to organize scientific events.”
Tarhan: “Critical concept: The patient's best interest”
Tarhan also warned, “In the military, it is said: ‘A commander is responsible not only for what is done but also for what is not done.’ A physician and a healthcare professional should be the same. They should be responsible not only for the treatments they perform but also for the treatments they do not perform. One type of harming a patient is leaving them without treatment. If a method has emerged somewhere in the world, we must follow it and apply it when necessary. If you say, ‘I only know this, I only apply this,’ then you become an expert who only looks at the situation from their own perspective. The critical concept is the patient's best interest. For the patient's best interest, it is necessary to benefit from all kinds of science, traditional, and modern methods.”
Personalized drug era
Prof. Dr. Nevzat Tarhan, stating that two serious revolutions have occurred in the world since the 2000s, said the following:
“One of these is the genetic revolution, and the second is the neuroscience revolution as of 2018. In the genetic revolution, the gene map was created. Now, the human genome is known. DNA is taken from a person, its sequence is determined, compared to the common gene in that genome map, and medication is given according to that person's genetic profile. DNA analysis is performed to check the drug's suitability for the patient and its metabolization rate. The liver is truly an amazing laboratory. When we look at how each gene functions, if it metabolizes that drug quickly, giving it to that person goes to waste. In developed countries, especially in the West, if doctors sometimes prescribe epilepsy medication that requires genetic testing, and the patient has an allergic reaction, the doctor is held responsible. There are doctors who have paid compensation for prescribing this drug without analysis, knowing such a risk exists.”
“The maximum form of treatment is personalized treatment”
Tarhan, speaking about the stages of treatment application, said: “If the disease has just started and does not respond to minimum treatment, optimum treatment is applied. If it still does not respond, maximum treatment, i.e., personalized treatment, is implemented. Treatment is carried out according to standards. For example, if a patient has not improved despite using medication for 6 months, personalized drug treatment is given. The method of prescribing medication according to DNA is now a tremendous convenience in conscious cases. In our field, we have greatly reduced the need for conscious patients to seek treatment abroad. Turkey has made groundbreaking initiatives in the healthcare sector. We have tried and are trying to do the same in our field.”
“The biggest challenge for psychiatric patients is that they are not understood”
Prof. Dr. Nevzat Tarhan, stating that the biggest difficulty for psychiatric patients is that they are not understood, continued as follows:
“The patient is suffering, in distress, and everyone advises them, ‘don't mind it, go out, it will pass, be your own doctor.’ This person comes to us. With personalized treatment methods, we look at the person's brain functions. We see that there is a 'war' in that person's brain. The signal flow in the brain is disrupted, the energy flow is disrupted, substances like serotonin and dopamine have decreased. The thinking brain, the feeling brain, the decision-making brain are not functioning properly; there is concrete biological evidence. When we show this, patients start crying. Even spouses bring the patient with good intentions. Some patients tell their spouses, “Didn't I tell you, look how sick I am.”
Prof. Dr. Nevzat Tarhan, who says that if the patient sees the treatment plan and believes in the illness and treatment, the brain secretes 40% healing chemicals; “The brain takes action. And there is the opposite. It's called the 'nocebo effect.' If a person believes in their illness even though they are not sick, if they say ‘I have this disease!’, it happens. For example; if they say ‘my head will spin’, their head starts shaking. In such a situation, the brain takes a position regarding the existence of the disease, makes perceptions, and produces chemicals. Therefore, even in internal diseases, the brain needs to be taken into account for personalized treatment.”
Artificial intelligence will reduce medical errors
Üsküdar Üniversitesi Founding Rector Psychiatrist Prof. Dr. Nevzat Tarhan 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 when faced with complex situations. This will minimize medical damages and provide a significant advantage. We physicians will collect important data. Radiology has started to become the field that best utilizes artificial intelligence. For example, we are currently using an AI and deep learning-based MRI device. The patent belongs to us. This device can provide a preliminary diagnosis to ensure that nothing is overlooked by the specialist. The specialist then confirms or refutes it. By performing brain imaging with artificial intelligence, we will be able to catch many things we missed.”