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Hi

Im a very hard man to medicate. I easyly get seronin syndrome because im missing the cyp2d6 enzym. On antipsycotic drugs my anxiety increases on big doses and i get a feeling that i dont know who i am. I havnt got good results on any drugs. Ive tried pretty much any drugs (abilify, seroquel, zoloft, ciprelex, effexor, cymbalta, zyprexa, fontex, lamictal, rivotril and latest lyrica with moclobomide etc.) Ive been in terapy for years and years. When i was seventeen i got zoloft for anxiety and depression. After 3 weeks i got well and had full recovery from the illness. 1

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Hi

Im a very hard man to medicate. I easyly get seronin syndrome because im missing the cyp2d6 enzym.

That isn't likely to cause serotonin syndrome by itself. It only means that drugs metabolized by CYP 2D6 build up more quickly, and possibly far too high. If that is the case, that takes bupropion, fluoxetine, paroxetine, duloxetine, venlafaxine, clomipramine, desipramine, imipramine, nortriptyline, atomoxetine out of consideration. Stay away from tramadol and dextromethorphan as well.

On antipsychotic drugs my anxiety increases on big doses and i get a feeling that i dont know who i am.

Haldol and risperdal are also metabolized via 2D6. Quetiapine(Seroquel) and ziprasidone (Zyprexa) aren't on my 2D6 list... A number of people have had decent anxiety relief from Seroquel, so that might be helpful to research.

Amitripyline is metabolized via CYP 2D6, but it can also be metabolized via 1A2, 2C9, and 2C19. You may be able to tolerate it if you start at a lower than normal dose. I don't know how much is metabolized through one isoenzyme or another, so you'd have to be careful.

Moclobemide is metabolized via 2C19, as are Celexa/Lexapro (citalopram/escitalopram) which might be reasonable to try.

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Hi and thanks for the answer. (sorry bouth my english skills)

I know that because im missing the genes that produce the cyp2d6 enzym, doesnt mean that get serotonin syndrome. But it means that im a poor metabolizer, and that i cant tolerate "normal" doses of the following medication, as you mentioned "bupropion, fluoxetine, paroxetine, duloxetine, venlafaxine, clomipramine, desipramine, imipramine, nortriptyline, atomoxetine out of consideration. Stay away from tramadol and dextromethorphan as well"

Iv

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