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Re: drug drama (for anyone good at chemistry) » socialdeviantjeff

Posted by chemist on April 11, 2004, at 14:05:35

In reply to Re: drug drama (for anyone good at chemistry), posted by socialdeviantjeff on April 11, 2004, at 0:48:01

my pleasure...you could have a very real genetic component that is responsible for the metabolism of these drugs. the CYP enzymes of most import for us are 1A2, 2C9, 2C19, 2D6, and 3A4. zyprexa's route is via the 1A2 and 2D6 routes, while halcion is primarily metabolized by 3A4 and inhibits 2C8 and 2C9, thus i would expect no interation (on the enymatic level) for zyprexa and halcion. now, abilify (aripiprazole), is metabolized via 2D6 and 3A4 but is not an inhibitor of 2D6, so i would not think there would be an interaction bewteen abilify and zyprexa as they are both metabolized (initially) by 2D6. zyprexa is metabolized in a minor way by 2D6, and apparently if you are deficient in 2D6 this does not affect zyprexa metabolism. all that said, anywhere from 8-10% of the population are classified as poor-metabolizers of 2D6 substrates (abilify) ad you might be one of them. thus, the result is a higher concentration of the active metabolite than if you were not in the 8-10% and given the same dose. now, you also mention tardive dyskinesia, and that is one of the so-called extra pyrimidal side effects that do arise in the use of anti-psychotics such as abilify and zyprexa. my take is that you might be a poor metabolizer and need to have you doses curtailed; or that you are simply being doubly-medicated with zyprexa and abilify to achieve the same therapeutic goal...please let me know if any of this helps, looking forward to your respone...all the best, chemist

> Thanks, Chemist! I appreciate the time you took to put your response together. I have some things to discuss with my pdoc. I appreciate it.
>
> Now I'm a novice at this sort of thing, so if I'm wrong please let me know. I looked up the ways these drugs are metabolized and Cytochrome P450 came up again and again. Could it be that the drugs aren't being metabolized properly due to a problem with this system? Could an excess of these drugs and/or their metabolites explain why I have such bad side effects? I really am a beginner in this stuff.
>
> TIA


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