Episode #33
When Medication Fails: What EEG Endophenotypes Reveal
Medication shouldn’t feel like guesswork, but for a lot of people it does, especially after a long string of “nothing worked.” We sit down with EEG and QEEG leader Jay Gunkelman to talk about a more grounded path: using brain endophenotypes to understand why the same diagnosis can respond to totally different medications, or to none at all. We dig into what shows up when you look at incoming EEGs from people referred specifically for medication failure. Jay explains why focal slowing can be a sign that the problem is local and organic, not something you can fix by medicating the entire brain. We also unpack spindling excess beta and what “overarousal” looks like in the data, plus why certain common medication choices can accidentally push the nervous system in the wrong direction. Then we get into the most overlooked conversation in psychiatry: epileptiform discharges without obvious seizures. Jay shares why spikes can still be clinically meaningful, how they can show up as false emotion or false memory, and why an empirical anticonvulsant trial can sometimes change everything. From addiction neurofeedback protocols (including alpha-theta and anterior cingulate targets) to ADHD subtypes tied to dopamine, norepinephrine, beta spindles, and discharges, the through-line stays the same: test first, then treat what you find. If this helps you think differently about ADHD meds, OCD treatment response, precision psychiatry, or neurofeedback planning, subscribe, share this with a colleague, and leave a review so more people can find brain-based care that actually fits. To learn more about Transformative Neurotherapy visit: https://www.TransformativeNeurotherapy.org Transformative Neurotherapy 570 Lincoln Ave. Bellevue, PA 15202 412-204-7397
