It absolutely can and does affect a person if they don’t get their dose, or don’t get the full dose. The thing is, it’s incredibly subjective, and depends heavily on the drug involved as well as the person involved (as well as any comorbidities, psychiatric or otherwise, that may be present).

If I miss my dose and it’s before about 1 in the afternoon, I’ll just take it late. Much later than that, and I’ll likely have trouble sleeping.

For me, there is no “medication debt” per se. I don’t believe the way the drugs interact with the condition itself actually lends itself to that concept at all, but others may experience it differently than what is enumerated in textbook cases.

But the thing is that, under the current circumstances, lawyers and judges have zero reason to be getting involved with this dudes psychiatric care and his legally-given and -obtained prescriptions. The dude is clearly leaning into the “misunderstood genius” or some similar narrative bullshit. This has just about zero bearing on the trial. He’s grandstanding because he or his lawyers think it will make one or more people on the jury sympathetic to him.

If I was the judge here, I’d have responded: “Didn’t ask; don’t care. At this point, I fully expect you to handle your medical and psychiatric care yourself.”