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.
hope it isn't against the rules to post these important links.
dx: fibromyalgia, IBS-C,Myofacial Pain Syndrome, Chronic Headaches, hypothyroidism,anemia, insomnia,mild depression.
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