2/11 Medication Metabolism in Neurodivergent and Chronically Ill People

Last week we talked about why neurodivergent and chronically ill nervous systems are more easily dysregulated.This week, we’re diving into how those same biological differences affect the way our bodies process medications.

Join the Duke Neurodiversity Advocates (DNA) for an in-depth discussion on how connective-tissue, autonomic, and neurological differences can change drug absorption, metabolism, and sensitivity — and why these variations often lead to disbelief or mismanagement in clinical settings.

We’ll talk about:

• Why people with Ehlers-Danlos Syndrome (EDS), POTS, dysautonomia, or chronic fatigue often metabolize medications or anesthesia faster than expected

• How liver enzyme differences (CYP450 variants), connective-tissue laxity, and altered blood volume impact drug distribution

• The implications for pain relief, sedation, and psychiatric medications — and why “standard dosing” often doesn’t fit

• Experiences of anesthesia resistance and local-numbing failure in EDS and hypermobile populations

• How to communicate effectively with providers about unusual drug responses without being dismissed

Scientific grounding:

• Hakim, A. J. et al., Ehlers-Danlos syndromes and anaesthetic considerations – British Journal of Anaesthesia (2017)

• Tinkle, B. T., Joint Hypermobility Handbook (2016): chapters on pharmacologic sensitivity

• Mathias, C. J., Autonomic dysfunction and altered pharmacodynamics in dysautonomia – Clinical Autonomic Research (2018)

• NIH MedlinePlus: “Why Genetics Matters in Drug Response” (CYP2D6 and pharmacogenomics)