THE REUPTAKE: A Neuropharmacology Fiction

Josh Dulovic has been managing his anxiety for so long that he no longer distinguishes it from his personality. It powers his work as a graphic artist at a remote design agency, drives the obsessive precision of forty-seven versions of a single wordmark, and fuels the illustrated magazine memoir he has been unable to finish for two years. His wife Lara calls it the static. His brother Sam calls it his antenna. His psychiatrist Dr. Debesy calls it hyper-efficient serotonin reuptake transporters. The prescription is escitalopram, 10mg, once daily. The Reuptake follows Josh from the first pill through fourteen months of pharmacological bargaining with himself: the gut protests of the 5-HT3 receptor onboarding, the therapeutic lag while somatodendritic autoreceptors slowly downregulate, the emotional blunting that flattens his anxiety and his art simultaneously, the CYP2C19 intermediate metaboliser result that explains why everything has been more intense than predicted, a serotonin syndrome event at four in the morning, and the augmentation with bupropion that adds a dopaminergic layer to the serotonergic floor. This is a novel about what it means to alter the fundamental mechanism of one's consciousness. It is about the question no leaflet answers: if the drug changes how you feel, create, love, and relate, is the person on the other side of the treatment still entirely you? The pharmacology is precise and accurate throughout. The answer is provisional, clinical, and honest. >A part of the Fictional Pharmacology Series.