Side Effects Include...

by RB_

Rating: teen
Tags: Horror, Twilight Sparkle, My Little Pony: Friendship is Magic, Dark
Length: 2992

Sometimes the medication can be worse than the disease.

Twilight Sparkle is hearing voices. That's bad! Luckily her doctor has just the right medicine for her to try.

A psychiatry horror story.

Preread by Love And What Came After!

Published 2024-02-16 23:10:01 UTC
Last updated 2024-02-16 23:10:01 UTC

Medication Regime

9/14/1009

"Right this way, Your Highness."

"Please, Dr. Pons," Twilight Sparkle said, waving a hoof. "Just 'Twilight' is fine. And may I call you—"

"'Dr. Pons' is fine," the cream-coloured stallion said. "I worked hard for my PHD."

"...Right, of course."

They entered the office, Dr. Pons waving Twilight in first. It was relatively tidy, and nicely decorated, though not without an air of sterility, like a room that was trying its best to appear cozy. Various picture frames and books lay upon the wooden desk at its center. Dr. Pons sat in the large chair on the far side of it; Twilight in the smaller one in front. The doctor’s degrees hung on the side wall, in full view of both patient and professional.

"I must say," he said, "it's an honor to attend to a princess such as yourself."

Twilight let out a nervous laugh. "Please, Dr. Pons, just treat me as if I were any other of your patients."

He nodded. "Oh, absolutely. I completely understand. Now, about your test results..."

Opening one of the drawers to his left with his magic, the unicorn pulled out a series of papers and arranged them on the surface of the desk. He scanned them briefly.

"Well, our scans picked up an abnormality in your brain," he said, turning his eyes back up at his patient.

Twilight sucked in a breath. "In my brain? Is that why I'm... hearing things?"

"We believe so," Dr. Pons said.

"Is it cancer?"

He smiled. "That's the good news, Twilight. It's nothing so serious, nor is it life-threatening. In fact, it can be treated with medication."

Twilight's eyes widened. "Oh! That's... ha! That's wonderful news." She smiled. "So, what is it?"

"Mind matter mites."

The smile quickly turned into a frown of confusion. "Mind... matter mites?"

Dr. Pons nodded. "Yes. They're a type of brain parasite native to the Everfree. They live in water and are usually contracted after the head has been submerged in contaminated water."

Twilight's eyes went wide and her face went white. "I have a parasite in my brain!?"

"Technically, you have several."

She slumped into her chair. "Oh Celestia..."

Dr. Pons put a hoof up. "Now, Twilight, not to worry. As I said, they're easily treated with medication. Just a small change to your brain chemistry and they'll die right off. You're lucky we caught them this early! You'll be okay. Just trust me, and we'll get this all sorted out in less than a week."

He said this with a reassuring smile, and, fool that she was, Twilight believed him.

Prescribed: Preditide 20mg.

The headline in the Canterlot Times read, "Princess Appears Agitated in Court, Leaves Early".

9/28/1009

"Twilight!" Dr. Pons said as he welcomed her back into his office. "How are you?"

"Just fine, Dr. Pons," Twilight replied, stepping through the doorway. Her wings ruffled as she sat down in the patient's chair, and the doctor followed her into his own.

"That's great to hear.”

"I hope you have good news for me?" Twilight asked, smiling.

"Ah, yes, about that," he said. "Our scans indicate that the mind matter mites in your brain haven't quite given up the ghost yet."

The smile fell from Twilight's face. "But, doctor, you said this would be sorted out in less than a week...?"

"Yes, well, I put you on quite a low dose of the medication to begin with," Dr. Pons explained. "Just to make sure you would tolerate it well. It seems a slightly higher dose will be required to put those pesky parasites out of their misery."

"Oh..."

"You haven't experienced any side effects from the medication, right?"

Twilight thought about it. "No, not that I've noticed... Just the voices. Chanting my name over and over."

"Well then, we should be fine to move to a higher dose," he said, still smiling. "I promise you, we'll have those voices quieted down by the next time we speak."

Prescribed: Preditide 40mg.

The headline in the Canterlot Times read, "Princess Cancels Court, Citizens Worried".

10/12/1009

"It's good to see you, Twilight," Dr. Pons said.

"Likewise," Twilight said, though it hurt a bit to do so. They filed into their usual positions.

"So," Dr. Pons said. "How have things been?"

"Not, um..." Twilight said. "Not great?"

He gave her a concerned look. "Oh? How do you mean?"

"Well, I can't stop clenching my jaw," she said. "It started the day after I began taking the higher dose. I just do it unconsciously. And it aches."

"Oh dear," he replied. "Is it at night or during the day?"

"During the day," Twilight said.

"Could you open your mouth for me?"

Twilight did so, and Dr. Pons peered in.

"Are you holding your jaw still?" he asked.

"I'm trying to."

"Yes, I'm definitely seeing some unconscious jaw movement," he said, leaning back into his chair, and Twilight shut her mouth. "Some tongue movement, too."

"Is this a side effect of the medication?" she asked.

"It can be," he said.

Twilight smiled. "Well that's okay then, since I won't be on it much longer. Right?"

"Actually," he said, "no."

Twilight blinked. "What do you mean? Are the mites still not...?"

"They seem to be resisting the medication," Dr. Pons said.

"But... but you said..."

He raised his hoof. "Now now, Twilight, calm down. We'll get this worked out. We'll just have to increase the dosage again."

"But—"

"In the meantime!" he said, cutting her off. "I'll prescribe you something to help with the jaw movements."

"Oh." Twilight seemed to deflate a bit. "Okay. You have something that can do that?"

"Of course!" he said. "Modern medicine is incredible."

Prescribed: Preditide 60mg, Metafergen 10mg.

The headline in the Canterlot Times read, "Where is Princess Sparkle?".

10/26/1009

"Nice to see you, Twilight," he said.

"You too, Dr. Pons," she replied with a smile. They settled into the usual seats.

"So," he asked, "how have things been?"

"A bit better," she said. "The medicine you prescribed for the jaw clenching has worked wonders, it's not even an issue now."

"Well that's fantastic!" he said. "And the voices?"

"I think they might have gotten a little quieter!" she admitted.

He beamed ear to ear. "Well, then the medication must be working."

She smiled back. "I guess so!"

Prescribed: Preditide 60mg, Metafergen 10mg.

The headline in the Canterlot Times read, "Princess Holds Private Audiences, Parliament Relieved".

10/26/1009

"Hello, Twilight!" he said, beaming.

She scowled at him. "I'm not in the mood for pleasantries, Dr. Pons."

She stomped past him into the office. The doctor froze for a moment, then followed after her. "Is something wrong?"

"This drug, Metafergen," she said. "I mentioned it to the castle physician, and he was quite alarmed that it had been prescribed to me."

"Oh?" Dr. Pons said, settling down into his chair. "I've been prescribing it to patients for many years, and it's had quite good results—"

Twilight stomped her hoof on the arm of the chair. "Prolonged use of Metafergen can cause cognitive issues, Dr. Pons."

"Well, yes, I admit it's a possibility," he said.

"So you knew!?"

"I was aware of the risks."

"Well I wasn't!" Twilight exclaimed. "I am the ruler of this nation, Dr. Pons! I can't afford to take risks with my mental faculties! You should have made me aware of this before you prescribed it to me!"

"Twilight, please, calm yourself—"

"Calm myself!? This is your fault!"

"Do you not trust me with your health, Twilight?" Dr Pons said.

The question caught Twilight off guard. "I— not if you're going to do things like this!"

"Then I won't," he said. "I made a decision, and it was in your best interests, but if you are not happy with that decision, then I acquiesce. The most important thing in medicine is the trust between a doctor and his patient, Twilight, and I value that trust absolutely. If I have broken that trust then I am deeply sorry, and you may choose to seek another doctor if you wish."

"I—ah..."

Twilight sank back into her chair.

"No, it's... alright. I don't want to find another doctor. But I don't want to be on Metafergen anymore."

"Done. Remember, that trust is both ways. I trust you, and you trust me, and together, we'll get you through this."

Prescribed: Preditide 60mg, ~~Metafergen 10mg~~.

The headline in the Canterlot Times read, "Princess Cancels Appointments Again".

11/9/1009

"Greetings, Twilight," Dr. Pons said, warmth in his voice.

Twilight gave him a thin smile. "Hello, Dr. Pons."

They sat down.

"Well? How have you been?" he asked, from across his big desk.

"The voices are still there," she said. "And the jaw clenching's back in full force. I'm worried about my teeth..."

"You could try wearing a bite guard at night," he said.

"The... jaw clenching is during the day," Twilight replied.

"Ah, right. Must've gotten my wires crossed. Well, you could also wear a bite guard during the day. They sell ones that you can just submerge in boiling water and then mold to your teeth now, it's quite ingenious."

"I... have some reservations," Twilight said. "I don't think I could wear something like that during social obligations, or during court, for example, and that's when the clenching is at its worst..."

"Well, even a little pressure taken off would be to your benefit," he replied. "These are your teeth we're talking about, after all."

"Right."

"Just give it a try," he said.

"Okay. Now, about the Mites...?"

He sighed. "Our scans show that the mites have not budged. Frankly, I don't understand it; they certainly should have keeled over by now. We can try raising the dosage again, if you'd like?"

"If you think that'll do it," Twilight said.

"I'm sure everything will be fine soon, Twilight," he said, with another of his reassuring smiles. "Just hold in there a little longer."

"Is there..." There was hesitation in her voice. "Is there anything else we could try? Maybe in conjunction with that?"

He leaned back into his enormous chair. "Well, there is one other medication that can be used to treat brain parasites like mind matter mites. It's called Aggralazal. We could try it, if you'd like."

"Do you think it would be more effective?" Twilight asked.

"It certainly couldn't hurt."

"Then I think I'd like to try it."

He nodded. "Done."

Prescribed: Preditide 80mg, Aggralazal 50mg.

The headline in the Canterlot Times read, "Princess is Undergoing Medical Treatment - Anonymous Source".

11/23/1009

"Twilight!" Dr. Pons said, waving Twilight into his office. "How have you been?"

Twilight looked haggard and pale. "Not great, doctor."

They took their places.

"Oh?" he said. "How come?"

"Every night since I started taking that new drug, I've thrown up," Twilight explained.

"Oh, that's horrible!" Dr. Pons said. "Tell me about it."

"Well, you told me to take it at dinnertime, with food," she said. "But immediately after taking it, I start to get nauseous. It builds and builds until eventually it all comes up."

"Hm," he said. "And this has happened every night you took the medicine?"

She nodded. "I thought about stopping taking it, but I just want all of this to be over... Please, tell me, has there been any change in the mites?"

He shook his head. She slumped down. "Oh."

"Perhaps we can try changing the medication," he said. "You're currently taking it in tablet form; your body may find it more tolerable if you try it as an extended release capsule."

"Oh. Okay! We can try that."

She paused for a moment.

"By the way," she said, "I saw that the newspapers have caught wind of my treatment here. You wouldn't happen to have any ideas as to who could have told them, do you?"

"Not a clue," he said. "I don't read the news much myself. It's always so depressing."

"Hm. Okay. Well, if you have any ideas, let me know."

Prescribed: Preditide 80mg, Aggralazal 50mg (capsule).

The headline in the Canterlot Times read, "What is the Princess Hiding?".

12/7/1009

"Hello, Twilight," Dr. Pons said. "And... who is this?"

"I'm Twilight's mother, Twilight Velvet," Twilight Velvet said.

"Well it's nice to meet you, Mrs. Velvet," he said, ushering them both into his office. "You can pull up a chair from the back wall there."

They all sat down. Twilight looked tired. Her mother looked disgruntled. Dr. Pons looked smooth as a cucumber.

"So, what do I have the pleasure of the two of you for today?" he asked.

Twilight looked down at the ground. Mrs. Velvet spoke up.

"I came as an advocate for my daughter," she said. "Given what she's been going through, I thought she needed a little support. She came crying to our house last night, you know that? She's under an enormous amount of stress."

"I'm very sorry to hear that," Dr. Pons said. "I understand what she must be going through."

"Do you?" Velvet asked. "Because, frankly, it seems to me all you've done is make the situation worse."

"Mom!" Twilight blurted out. "You said you wouldn't..."

"Look," Velvet said. "She says the voices she's been hearing have only been getting louder over time. And then you prescribe her some dangerous drug, and now she keeps throwing up every night! And to top it all off, she's gained twenty pounds since all this started."

"So she's still throwing up, even with the capsule?" he asked.

"Apparently!" Velvet said. "Look, I don't want to have a go at you, but this is my daughter. I want what's best for her, and this isn't it. Isn't there something you can do to help?"

Dr. Pons leaned back in his chair. "Well, for the vomiting, we could cut back on the dosage of Aggralazal. I do believe that it's in her best interests to keep taking it. And we could raise the dosage of Preditide again. To deal with the stress, you could try meditation, or exercise. I quite recommend meditation, actually; I do it every day." He said it with a smile, lying through his teeth.

"Meditation...?" Twilight muttered under her breath.

"As for the matter mites, all we can do is keep medicating," he said. "Or..."

"Or?" Velvet said.

"We could try electroconvulsive therapy."

"What's that?" Velvet asked.

"Well, we would have a clinician attach electrodes to your temple," Dr. Pons said. "Then, we'd send an electric current through your brain—"

"What!?" Twilight exclaimed.

"It's perfectly safe," he said, holding up a hoof. "Aside from some memory loss, there's no major side effects—"

"I'm not going to let you electrocute my brain!"

He held up his other hoof. "Okay, Twilight, I understand. It was just a suggestion. Something to consider if the medication truly isn't working."

Twilight slumped back into her seat, her vision locked on her hooves.

"Now, in the meantime, I suggest we go through with the changes I proposed to your medication regime," he said. "If there are no objections...?"

Prescribed: Preditide 100mg, Aggralazal 30mg.

The headline in the Canterlot Times read, "Protestors Demand Answer From Princess".

12/21/1009

"Hello, Twilight," Dr. Pons said. "Is your mother not here today?"

Twilight shook her head as she passed him. "We had a falling out."

"I'm sorry to hear that."

She sat down, and so did he. She looked tired. He looked the same as always.

He opened his mouth, but she spoke first. "Please tell me there's been some change in the mites."

He folded his hooves over the desk. "I'm afraid not."

"Oh."

They sat in silence for a few moments.

"Has the vomiting...?"

"No. It's not every night, now, but it's still happening."

"I see." He sighed. "I think it's time we thought seriously about electroconvulsive therapy. This has gone on long enough."

"It's okay," Twilight said. "I think I have another idea."

He cocked an eyebrow. "What's that?"

"Don't worry about it." She smiled. "Soon, this will all be over."

Prescribed: Preditide 100mg, Aggralazal 30mg.

The headline in the Canterlot Times read, "Princess Remains Missing".

12/24/1009

Dr. Pons hurried through the hospital's corridors. It had been hard, getting through the mob of ponies outside, then convincing the people at the reception desk to let him see her, but he'd managed it.

Eventually, he found her room. It wasn't hard to differentiate; there were guards standing outside the door. Dr. Pons told them who he was, and they let him through. There was a doctor standing over her bed.

"What happened to her?" Dr. Pons asked.

The doctor started. "Who are you?"

"I'm her doctor."

"Oh." he turned back to the bed. "Well, there's not much either of us can do at this point. She's in a coma."

Dr. Pons walked up to the bed, saw the purple alicorn laying there, all intubated, her eyes closed.

"How?" he asked.

The doctor pointed at a jar full of yellow liquid sitting on the table beside her. Inside was a grey piece of meat—Dr. Pons recognized it as part of the cerebellum.

A piece of her brain.

"They found it next to her," the doctor said. "They think she teleported it out herself. Maybe on accident. Who knows."

Dr. Pons took a quick intake of breath. He turned his attention back to Twilight Sparkle, or what was left of her.

"If she'd just trusted me..." he said.

But inside, he was thinking something different.

Inside, he was thinking:

At last, she's the perfect patient.

Author's Note

I want to note that I am fully on board with the field of psychiatry, and I like my psychiatrist, but this is mostly autobiographical and frankly I'm at my limit.