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I have a character in one of my stories with a severe disease. It requires regular medical therapy, like pills, or else they could die quickly after. I cannot find any specific diseases like this, that require constant, regular medicine, and they can generally live a normal life outside of said regular medicine.

The closest things I can find is either brain cancer plus chemotherapy, or HIV, but neither of these are exactly what I'm looking for.

Do there exist any diseases or conditions like this?

Some side effects, if possible (of either the medicine or the condition), include:

  • Seizures
  • Irregular sleeping
  • Premature death
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closed as off-topic by JDługosz Feb 23 '17 at 1:22

This question appears to be off-topic. The users who voted to close gave this specific reason:

  • "This question does not appear to be about worldbuilding, within the scope defined in the help center." – JDługosz
If this question can be reworded to fit the rules in the help center, please edit the question.

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    $\begingroup$ Epilepsy can often be controlled with drugs, and can have those side effects if drugs are not taken. $\endgroup$ – ohwilleke Dec 6 '16 at 1:16
  • $\begingroup$ they could die quickly after...define "quickly" please. Is this within hours, days, weeks? Maybe a schizophrenic ‎whose "other half" will immediately seek suicide? $\endgroup$ – MonkeyZeus Dec 6 '16 at 16:46
  • $\begingroup$ What happens if they stop taking the medicine, start showing signs of the disease, then start taking medicine again? Will that lead to death, or can they recover? $\endgroup$ – BruceWayne Dec 6 '16 at 21:44
  • $\begingroup$ The question is far too broad. There are not enough conditions to limit the answer to even a small handful of diseases, let alone help decide the best one. $\endgroup$ – Samuel Dec 6 '16 at 22:13
  • $\begingroup$ Drug addiction can work like this. See, for example, TNG:Symbiosis $\endgroup$ – J... Dec 7 '16 at 2:46

13 Answers 13

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There are many, many diseases that require 'maintenance drugs':

Heart disease

Requires beta blockers, diuretics, statins for cholesterol management. Risk of death due to heart attack or stroke is elevated, but not predictable - but if you take beta blockers and then stop them abruptly, then the results can be very serious.

Diabetes

Requires insulin injections or an insulin pump. You die within a few days if you don't have insulin.

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    $\begingroup$ +1 for Diabetes, it covers seizures if sugar is too low, irregular sleeping especially if patient has sleep apnea quite common with obese people . Diabetes is called silent killer, it could be controlled but many people don't do it. $\endgroup$ – slobodan.blazeski Dec 5 '16 at 22:02
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    $\begingroup$ Add HIV to the list. Many people with it can now live (and I think fairly normally) for decades by taking anti-retroviral drugs. $\endgroup$ – jamesqf Dec 6 '16 at 5:43
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    $\begingroup$ @slobodan.blazeski Just remember that having diabetes isn't shorthand for being fat. As a fat person who doesn't have the condition with multiple friends who do that have been skinny throughout their lives, I'd like to think that isn't the case. $\endgroup$ – Papayaman1000 Dec 6 '16 at 11:30
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    $\begingroup$ To clarify the difference between Type I and Type II diabetes: Type I occurs completely random and is neither caused by nor results in adiposity. If the patient regularly measures their blood sugar and regulates it with insulin injections, it doesn't need to affect their lifestyle at all. Type II is caused by fat and lack of exercise (although genetics also matter). It can only partially be suppressed with insulin and requires to change eating behavior. $\endgroup$ – Philipp Dec 6 '16 at 16:13
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    $\begingroup$ That means Type I diabetes is likely the better option for storytelling when you don't want the character to have any limitations except their insulin dependence. But keep in mind that type I diabetics don't need insulin when they don't consume any carbs. So they can stretch their insulin stock a lot when they eat mostly fat and protein. $\endgroup$ – Philipp Dec 6 '16 at 16:17
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Don't tell the audience what disease it is, just paint it as terrible.

Disclaimer:

Unless the story is about how the cure of the disease came by and you want to go all biological and medical on your story, you can give it a flair of mystery by not going into too many details.

Make your character really scared to miss his medicine. Drop a hint on how rare the disease is. Draw a plot on obtaining more rare medicine.

Beforehand, you should flesh out your disease, so you don't fall into contradictions and/or plot holes later on. You should list your symptoms and/or side effects any way you want it. You can take one real disease and tweak the symptoms. Make it consistent, if you have someone in the medical/biological fields you can rely on, ask him what he thinks of this fictional disease (hint: you can also ask in the stack... >.<)

Example: Kaori from Your Lie in April.

her disease disables her in the final third of the series, and proves to be fatal by the end of the story.

We never get to know what is the disease she has, just the symptoms.

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    $\begingroup$ Even if the author will never tell the audience what disease it is; if they do not know it themselves they will eventually mess up by contradicting themselves. There's always huge amounts of data behind every scene, no matter if you're ever told any details or just an effect that seems random to you $\endgroup$ – dot_Sp0T Dec 6 '16 at 10:30
  • $\begingroup$ @dot_Sp0T that is why I mention in the answer body that the author should take a real disease and change it slightly, listing symptoms and side effects. Maybe it is not clear as it is, i blame the language barrier. I will try to improve clarity on that part. thanks $\endgroup$ – Mindwin Dec 6 '16 at 10:35
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    $\begingroup$ I think it would be really cool if you went the whole story without saying what the disease is, just that it's very deadly if you don't take your medicine, body parts could deteriorate to the point of loss, seizures, etc. Then at the end reveal that it is actually Diabetes. It would give and "awe" moment and could draw parallels to how many people don't realize how severe the disease is. $\endgroup$ – DasBeasto Dec 6 '16 at 13:32
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A friend of mine had to have her thyroid removed because of Graves' disease. The thyroid secretes hormones that are necessary for protein synthesis, and if my friend doesn't take her daily pills (which give her the hormones she needs) she'll slowly deteriorate and die (within about a month, I think?)

There are probably several similar circumstances with removal of various organs.

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  • $\begingroup$ Losing your thyroid due to thyroid cancer will do this as well. $\endgroup$ – David Schwartz Dec 6 '16 at 1:22
  • $\begingroup$ She'd likely last years. They wouldn't be comfortable, but it would take far longer than a month. $\endgroup$ – Samuel Dec 6 '16 at 22:09
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Blood Clotting Disorders

Blood clotting disorders can cause severe damage or death, depending on where the clot forms and/or lodges. Anticoagulants need to be taken regularly, and if your character has a particularly severe case of clotting, missing a dose could prove devastating, particularly if the clot lodges in the lungs or the brain.

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Many stories have such a plot device, but typically the protagonist has been poisoned by the antagonist and needs to perpetually take doses of the antidote. The actual poison and antidote are hand-waved away.

You could posit a persistent super-malaria which requires Artemisinin doses for life. If you miss a few days, you die.

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We're likely a few years from a workable tratment for this, but FFI meets most of your criteria.

https://en.wikipedia.org/wiki/Fatal_familial_insomnia

You have more and more interrupted sleep until you stay awake forever, slowly getting more crazy until you die. It's also genetic, so there's no "cure" until we learn how to safely rewrite DNA.

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My recommendation is a disease resulting in the release of an acetylcholine antagonist into the blood stream. The source could be congenital or the result of a bacterial or viral infection. Such chemicals are produced by bacteria in nature and appear as components in the venom of many animals.

The action of the drug could either be to bind with, and neutralize the acetylcholine antagonist (like an anti-venom) or to attack and degrade the bacteria/virus. In the second case, much like HIV, the treatment is not sufficient to completely eliminate the pathogen from the body and stopping the treatment results in a rapid resurgence of the pathogen.

In either case, failure to take the required prophylactic treatment results in a spike in the amount of acetylcholine antagonist in the blood stream and the elimination of the neurotransmitter acetylcholine from the victims body. Dizziness and nausea, followed by loss of equilibrium and muscle control, followed by paralysis, followed by loss of respiration, heart function, and death.

Does this fit what you are looking for? I imagine you can use any clinical description of death by venom to provide the details for the crisis your character will undergo if denied treatment.

If this is too scifi, you could go with a viral or bacterial meningitis. With a slight mutation, you could get a viral meningitis that will be fatal if not kept in check with anti-viral drugs. Alternately, you could conceive of a bacterial infection that can be degraded but not eliminated with antibiotics due to the difficulty of treating the infection in the spinal column, some level of antibiotic resistance, or a combination of both.

With this infection, failure to continue treatment results in a fatal case of meningitis. The time required for the symptoms to become acute and then fatal could vary widely to fit your story. There are existing meningeal infections that cause coma and death in under 24 hours after infection, and there are those that require weeks to develop, with all points in between.

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Narcolepsy

This is not exactly what you are asking for, i.e. a disease that will cause death directly if medicine is not taken. However, narcolepsy could cause death indirectly if the person is involved in a dangerous task, such as driving, flying, etc., when they fall asleep.

Also detracting from this as a possible solution is the fact that currently there is no certain cure for narcolepsy. However, orexin supplements show promise as a treatment.

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  • $\begingroup$ indeed. Without my medication to control my narcolepsy I'd very quickly become pretty much like a zombie and be completely incapable of functioning on a normal level. $\endgroup$ – jwenting Dec 7 '16 at 7:50
  • $\begingroup$ Yes, I learned about orexin's importance after experiencing how Learned Helplessness can suddenly cause orexin levels in the brain to drop. It's quite impressive. $\endgroup$ – Thom Blair III Dec 7 '16 at 11:09
  • $\begingroup$ I'm taking serotonin reuptake inhibitors to combat the symptoms, which seems to work reasonably well. Not perfect, but I'm functional. $\endgroup$ – jwenting Dec 7 '16 at 11:44
  • $\begingroup$ That's great! I've heard of SSRIs, but not SRIs. I'll ask my doctor about them. Thanks! $\endgroup$ – Thom Blair III Dec 7 '16 at 11:47
  • $\begingroup$ Clomipramine in a low dose works for me. $\endgroup$ – jwenting Dec 7 '16 at 11:48
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I would recommend some form of kidney or liver failure. If the systems that filter toxins out of the bloodstream fail, constant intervention is required to perform that function, or it's fatal.

In fact, a regular life outside of regular medical treatments could be used to describe the process of dialysis, which is used for kidney failure. Moreover, both kidney and liver filaure typically result in circulatory dysfunction as well, which can manifest in the symptoms you describe.

For that matter, people who have organ transplants require anti-rejection medications for the rest of their lives, to prevent their immune systems from attacking and destroying their transplanted organs, so you could go that route. Your character got a kindey or liver transplant, and in the absence of medication, their transplanted organ gets attacked by their immune system, and they begin suffering from the symptoms of both organ rejection and liver/kidney disease.

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Have a look at Addison's disease. Patients have to take cortisole pills once or twice daily and increase the dose in stress situations. A so-called Addisonian crisis can lead to death within a few days.
https://en.wikipedia.org/wiki/Addison's_disease

Alternatively Diabetes insipidus. Those patients suffer from excessive urine production, like up to twenty liters a day. Without treatment they have to drink the same amount, otherwise they die from dehydration. But even if drinking enough they can still get life threatening electrolyte disorders. The urine production can be normalized with DDAVP, administered as nasal spray once or twice daily. https://en.wikipedia.org/wiki/Diabetes_insipidus

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In the most general sense, look for chronic diseases or missing organs.

As people have already mentioned, hormonal diseases such as cortisol production issues (Addison's) and hyperthyroid (Graves') or hypothyroid (Hashimoto's). They will all cause death and a host of other issues if left untreated for long due to your body trying to compensate.

Sleep problems are a common side-effect due effects to melatonin imbalances. Even people with hypothyroid who tend to almost hibernate can still have insomnia (they can pass out from tiredness instead of actually sleeping).

Seizures are a bit more difficult. I thought that requires neurological issues. You could go for pernicious anemia (inability to properly absorb B12). This one requires regular injections. Will damage your nervous system if not treated. Other symptoms are similar to other types of anemia (tiredness).

It also depends on the time you want your character to be able to go without medicine. People with Addison's can die rather quickly without medicine. People with Graves' should be able to go a bit without medicine, but will also quickly wither away to nothing (cannot eat enough to keep up the increased metabolism speed). People with hypothyroid can go for years without medicine, though they wouldn't be worth much (think of an animal in hibernation). People with pernicious anemia can go until their B12 stores run out (the body builds up stores) which should be several months. All the timings also depend on the severity of the disease. I gave estimates for rather bad cases.

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Immune System Suppression

If you're willing to make a disease up for the sake of story, you could have one where someone's immune system is suppressed or completely eliminated, and they require a drug to stay alive. Such a plot device has been used in Stargate SG-1, in the form of the drug tretonin.

In SG-1, when tretonin is injected into a normal human being, it eliminates their immune system, leading to life-long dependence on the drug. In Jaffa, a race in Stargate that is derived from humans but with a genetic dependency on another alien species for their immune systems, tretonin allows them to replace their dependency on an alien species with a dependency on the drug. In either case, the condition ("disease") of lacking an immune system means that if you miss a dose of tretonin, you will die quickly if you do not take more.

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Malaria

Malaria won't immediately cause death if the medicine is not taken but will cause it after some time.

It causes Seizures, if a fever attack erupts in the middle of the night you can have Irregular sleeping and can surely cause Premature death.

To treat and slow down Malaria you can take pills every day.

Source: https://en.wikipedia.org/wiki/Malaria

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    $\begingroup$ I want to play FarCry 2 again... $\endgroup$ – Goufalite Dec 6 '16 at 10:28
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    $\begingroup$ I exactly thought that while reading the OP ;) $\endgroup$ – A.Danzi Dec 6 '16 at 10:29
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    $\begingroup$ No. You treat malaria and it's gone or possibly knocked into hiding. I carried it for more than 20 years with zero symptoms and zero medicine. (It definitely was in hiding those years as I didn't go within several hundred miles of the malaria zone in those years.) You take regular pills in the zone as prevention, not treatment. $\endgroup$ – Loren Pechtel Dec 6 '16 at 21:56
  • $\begingroup$ Since the disease is still there I would call it treatment, not prevention. To prevent is to avoid getting sick. $\endgroup$ – A.Danzi Dec 7 '16 at 9:21

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