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BfromNJ

How does being a rapid or ultrarapid metabolizer affect tapering or withdrawal?

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BfromNJ

So I am an ultrarapid metabolizer on the CYP450.  I had the genomind test done.  So it turned out the mirtazapine is one of the drugs that was in my "use with caution" column.   Basically I guess I metabolize this drug quicker and I am supposed to use caution when this drug is taken "in the presence of inducers" (ie other drugs in the CYP450). It can make the drug less effective.  With that being said, does anyone know that being I am an ultrarapid metabolizer , will this affect my taper/withdraw? 

 

My doctor had indicated when I started the med that this really just meant that the mirt. would be less effective when I take another med that is an inducer or drink coffee, smoke, etc.  

 

 

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Altostrata

What this means is you might have to take higher doses to get an effect from mirtazapine when you're taking it. If you also ingest an inducer (could be a drug, a supplement, or even a food) of the same liver enzyme, your metabolization of the original drug will be speeded up even more, to the point you might experience withdrawal symptoms.

 

The danger for rapid metabolizers is that they can handle such high doses of drugs without side effects, doctors may overlook the risk of gradual organ damage over time.

 

You are not taking a particularly high dose of mirtazapine.

 

This doesn't mean anything for tapering. You taper to the rate you can tolerate. If you get withdrawal symptoms, you taper more gradually.

 

Generally, these genetic tests are useful only to identify potential drug-drug interactions for drugs that you are considering taking or already taking. They don't indicate anything about withdrawal.

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Vonnegutjunky

Also it depends on if the drug your taken is converted to its active form via cyp450.

 

if it is converted to its active form via cyp450,  you can get too much of the active drug into your system at once, and the rest of the enzymatic pathway doesn’t clear it, meaning a low dose can feel like an overdose. 

 

Here is is a nice little chart. 

 

https://selfhacked.com/blog/cyp-enzymes-interact-supplements-related-genes/

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BfromNJ

Thanks.  Very useful.  So basically im screwed coming and going.  Lol.  🙄😂

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Rachellynn

Is there somewhere to run raw data from 23andme through to find this information out? I too suspect liver issues with/from these drugs🙄

 

ive been told I’m a slow oxidizer but not sure if that’s the same thing. 

 

Thanks!

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Vonnegutjunky
4 hours ago, BfromNJ said:

Thanks.  Very useful.  So basically im screwed coming and going.  Lol.  🙄😂

 

Lol,I think we all are! Regardless of metabolic issues 😂😂😂

 

honestly, just becuse you have the gene doesn’t mean it’s turned on. It could be, mine actually turned on, and now I know why I had such an extremely adverse reaction to a once previously well tolerated medication. 

 

But becuse you are susceptible, I would say just go slower with your taper than what’s suggested, and you will probably have more intesne waves than others, if your gene has expressed. Also take this advice as a grain of salt becuse I am only speaking from my personal experience and I am in way an expert. (Mod Note:  I think member meant to say "I am in no way an expert".) Just my own research from what happened to me. 

 

 

Edited by ChessieCat
added mod note

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Vonnegutjunky
13 minutes ago, Rachellynn said:

Is there somewhere to run raw data from 23andme through to find this information out? I too suspect liver issues with/from these drugs🙄

 

ive been told I’m a slow oxidizer but not sure if that’s the same thing. 

 

Thanks!

The only place I know of that will do it online is through selfhacked, it’s called selfdecode, it’s on their site, I don’t know what the charge is. 

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ChessieCat
4 hours ago, Vonnegutjunky said:

I am only speaking from my personal experience and I am in way an expert. (Mod Note:  I think member meant to say "I am in no way an expert".) Just my own research from what happened to me. 

 

Made the above correction to this post about what I think Vonnegutjunky really meant.

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BfromNJ

my doctor ordered it through genomind.

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Vonnegutjunky

Hers was done through 23 and me, she has raw data, it’s different and needs to be decoded. 

 

Yes Chessie! Thank you! 

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Bee5

Hi All,

What is the name of this test? i.e. how would I enquire about it? Is is the CYP450 metbabolism genotype test?

Regards,

Bee5

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BfromNJ

My psych doctor did it.  They swan your mouth and send it out.  I didnt find it useful in the long run as far as helping with side effects knowledge etc.  And most ins doesnt cover it.  

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Bee5

Fair enough. But I think that this should be a standard test for every patient BEFORE being put on psychotropic drugs. This could avoid so much toxicity and akathisia!

Do you know how much the test costs?

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BfromNJ
8 minutes ago, Bee5 said:

Fair enough. But I think that this should be a standard test for every patient BEFORE being put on psychotropic drugs. This could avoid so much toxicity and akathisia!

Do you know how much the test costs?

300.00.    

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Bee5

Ok, that is quite pricey; but if you go through people's polypharmacy stories on this forum, I would say the price is worth it if it means that no doctor will prescribe multiple medication to vulnerable people.

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BfromNJ
6 minutes ago, Bee5 said:

Ok, that is quite pricey; but if you go through people's polypharmacy stories on this forum, I would say the price is worth it if it means that no doctor will prescribe multiple medication to vulnerable people.

Right.  But a simple check by the doctor for interactions isn't too much to ask.  I don't see why they dont simply use drugs.com.  we all can do it here. I was inpatient and had no access internet so I trusted them.  All three meds interact.   They should know better without having to do genetic testing.   

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Bee5

But they DON'T! My first psychiatrist had me on SIX psychotropic meds SIMULTANEOUSLY. It really is a miracle that I survived!

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