for those who cant find an antidepressant to work for them

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harry4
Veteran Member


Date Joined Mar 2005
Total Posts : 1449
   Posted 4/18/2007 2:34 PM (GMT -7)   
 
this info may be useful for people who dont respond to some meds, especially antidepressants, must admit I hadnt heard of it earlier sad
recovered former longtime anxiety and panic attack sufferer and helper of other sufferers  but no training or  qualifications in medicine or psychology, any remarks that may be taken as advice must be confirmed with doctor or other health professional
emails are welcome but do mention healingwell to avoid risk of deletion as spam


sweeterthanhoney
Veteran Member


Date Joined Oct 2005
Total Posts : 540
   Posted 4/18/2007 7:36 PM (GMT -7)   
Harry,
thanks for posting this.  This is something I have tried to bring to peoples attention, but not too many seem interested.  I've posted it here on Healingwell on the depression board and a few other places.
 
Here is some of what I have posted in the past:
 
CYP2D6 (cytochrome P450 2D6) acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers, opiates, neuroleptics, antiarrhythmics and a variety of toxic plant substances. Some 7- 14% of the population has a slow acting form of this enzyme and 7% a super-fast acting form. Thirty-five percent are carriers of a non-functional 2D6 allele, especially elevating the risk of adverse drug reactions when these individuals are taking multiple drugs. Drugs that CYP2D6 metabolizes include Prozac, Zoloft, Paxil, Effexor, hydrocodone , amitriptyline, Claritin, cyclobenzaprine, Haldol, metoprolol, Rythmol, Tagamet, tamoxifen, and the over-the-counter diphenylhydramine drugs, Allegra, Dytuss, and Tusstat. CYP2D6 is responsible for activating the pro-drugs codeine and other opioids into their active forms. The analgesic activity of the drugs is therefore reduced or absent in CYP2D6 poor metabolizers. Refer to list for substrates, inhibitors and inducers of CYP2D6.

Genelex offers improved detection rates using an extended Cytochrome P-450 2D6 DNA mutation panel. This test identifies 12 small nucleotide variants and two gene rearrangements in PCR-multiplex format, providing increased sensitivity and quality performance. This CYP2D6 Mutation Detection Panel is the most extensive on the market and covers over 93-97% of poor metabolizer phenotypes. Analytical specificity and sensitivity for detection of these mutations are >99%.
 
Here is a link to another site with lots of info and case studies.
 
 
This may explain why my hubby is on 900mgs of Effexor XR, under a pdocs care. confused

hope it isn't against the rules to post these important links.

 

Blessings,

sweet



dx: fibromyalgia, IBS-C,Myofacial Pain Syndrome, Chronic Headaches, hypothyroidism,anemia, insomnia,mild depression.
 
Meds:
Clonazapam .25mgs, Oxy IR 2.5-3xs/day 5 mgs at bedtime, Synthroid, Zopiclone, flexeril or baclafen,tapering off L-tryptophan, starting Buspar :X
 
Supplements:  Licorcise extract, Seriphos, professional vit/mineral, magnesium/malic acid, B#5, probiotic, Ester C, P5P[B6 supplement]
 
Daughter Jerica 17, Dx: Crohn's, Imuran 150 mgs, amitriptyline 20mgs,   lactaid pills, calcium 1000 mgs/day. Forvia, waiting for first Remicade infusion
 
 Husband with treatment resistant depression   Effexor-900mgs
 
                                     
Jerimiah 29:11                      
 


Howlyncat
Elite Member


Date Joined Jan 2005
Total Posts : 24909
   Posted 4/19/2007 12:14 PM (GMT -7)   
Thanks for the input Harry and Sweet......
    Contribute today to support Healing Well Forums...Donate @
 
Co Mod ..Crohns Forum
Co Mod A/P Forum
Moderator ....Alzheimers Forum 
 
Dx with Crohns ,pyoderma gangrenosum ,Anxiety and panic
 Way to many meds to put down ..........
 
Take that Lil step ..I will hold your hand and we will make big strides
 
                             
 
   LYN                               
                          
                                  


karenb
Regular Member


Date Joined Apr 2007
Total Posts : 58
   Posted 4/20/2007 2:38 PM (GMT -7)   
Thanks for the helpful information. It can shed some light on why some people are unsuccessful with medications. It seems to me that not all doctors are aware of these drug metabolism problems.

sweeterthanhoney
Veteran Member


Date Joined Oct 2005
Total Posts : 540
   Posted 4/22/2007 5:35 PM (GMT -7)   
Karen,
I think most drs, especially if they are a pdoc know about this problem, they just don't want to do the testing needed as it is expensive, and would be too time consuming to test everyone.
 
They'd just rather we spend the money  and time trying to find a drug that works for us! nono    Just kiddin', I don't know that, it just sometimes feels like that!  We brought this to my hubby's pdocs attention, since he is currently up to 900 mgs of Effexor XR, which, in a normal person, would probably kill them.  He was aware of this metabolism problem.  Didn't seem to think there was anything that could be done, and since Effexor has worked the best on him, to stick with it!  He's even drinking grapefruit juice with it in hopes it will enhance the effects of the med!
 
Only my hubby! eyes    The main side effects he has are profuse sweating, constipation and some sexual difficulties, but says they are nothing as long as he can feel "normal".  To bad it isn't consistant yet.
 
Sweet
dx: fibromyalgia, IBS-C,Myofacial Pain Syndrome, Chronic Headaches, hypothyroidism,anemia, insomnia,mild depression.
 
Meds:
Clonazapam .25mgs, Oxy IR 2.5-3xs/day 5 mgs at bedtime, Synthroid, Zopiclone, flexeril , Buspar 7.5 mgs 2xs/day
 
Supplements:  Licorcise extract, Seriphos, professional vit/mineral, magnesium/malic acid, B#5, probiotic, Ester C, P5P[B6 supplement]
 
Daughter Jerica 17, Dx: Crohn's, Imuran 150 mgs, amitriptyline 20mgs,   lactaid pills, calcium 1000 mgs/day. Forvia, starting Remicade Apr 23/07
 
 Husband with treatment resistant depression   Effexor-900mgs
 
                                     
Jerimiah 29:11                      
 


SarahP
Veteran Member


Date Joined Mar 2005
Total Posts : 1185
   Posted 4/23/2007 6:36 AM (GMT -7)   
Kinda ruffles your feathers to know there are people with this issue, and docs won't always look for it. People don't usually take those medications without a serious need, and to let it go when they don't work is just sad.
I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.

Co-Moderator for : Chronic Pain, Fibro


Howlyncat
Elite Member


Date Joined Jan 2005
Total Posts : 24909
   Posted 4/28/2007 2:39 PM (GMT -7)   
Bumping to top for new members
    Contribute today to support Healing Well Forums...Donate @
 
Co Mod ..Crohns Forum
Co Mod A/P Forum
Moderator ....Alzheimers Forum 
 
Dx with Crohns ,pyoderma gangrenosum ,Anxiety and panic
 Way to many meds to put down ..........
 
Take that Lil step ..I will hold your hand and we will make big strides
 
                             
 
   LYN                               
                          
                                  


stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 4/28/2007 5:34 PM (GMT -7)   

Thanks for posting this info...........I had not heard of it before but will read  up on it.

It is very technical and I admire the people here that got all that.

You guys are the  best. yeah


 
Respectfully
 
Kitt
 
Depression 25 years, Husband Crohns Disease 30 years
__________________________________________________ 
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.”
Rosalyn Carter
 

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