The MEQ and the advent of Circadian Medicine
Prescribing medications is headed for significant refinement of traditional time-of-day medical notations (AM, HS, etc.), considering the considerable inter-patient variation in chronotype and circadian rhythm phase. The MEQ method, based on self-scoring without the need for additional appointments, will enable pinpointing the schedule in the context of the patient’s circadian cycle of drug sensitivity.
There is a growing realization that the circadian modulation of response to medication can vary widely both within a drug class and between individuals, whose cycle of receptivity can vary by up to 6 hours or more. Directly determining circadian rhythm phase by the classical evening melatonin-onset marker is complicated and expensive and will remain inaccessible to most patients. The strong correlation of the melatonin rhythm with the MEQ score makes a close approximation of melatonin timing possible. The MEQ can therefore provide a benchmark for chronotherapeutic delivery of light or drugs and provide physicians with a new tool for personalized medicine.
Fine-tuning of dosage can be enhanced, considering that the morning anchor point for AM administration, for example, will vary between patients. Practitioners will gain a deeper grasp of time-based variations in medication administration by referencing the MEQ score and, inferentially, circadian rhythm phase – an approach that has maximized the antidepressant response to light therapy. Doctors can also track potential changes in circadian phase during treatment. Repeated utilization of the MEQ will allow patients to follow the course of phase adjustments or stability in conjunction with circadian drug administration schedules.