Posted by Adam on August 9, 2001, at 20:27:27
In reply to Re: I may need help...., posted by medlib on August 9, 2001, at 12:13:43
Hey medlib,
You're plenty brainy enough for me. I've learned quite a bit of use from you already. I've never taken codeine, nor would it be a good idea for me to, these days! However, a long time ago I had some wisdom teeth out, and for the aftermath, the oral surgeon gave me some vicondin. I really did love vicodin. Anyway, since I had a rather stellar response to that close cousin of codeine, it now seems quite unlikely that I am 2D6 deficient. I guess I'm just hypersensitive to certian drugs and/or their metabolites.
I took my b.p. and pulse tonight: 140/85, 95 resting (!). Pretty weird. I'm normally 120/80 at most, and about 70 resting at most. We'll see what tomorrow brings.
There may be something empirical I can do with the grapefruit juice idea...can we take it to that thread?
> Adam--
>
> What an interesting, if somewhat convoluted, theory! The nice part about it is that it's easy to test empirically by d/cing the benadryl. If you are right, you'll have no more SNS symptoms, so no further action re selegiline may be necessary. Real pheos are quite rare and in every aspect a pain in the rear. BTW, it is not necessary to be polymorphic for CYP2D6 to have the reactions you do to benadryl; it produces the same effects in me. I took my first 25mg. dose for a rash; 10 min. later, while driving to school, I fell asleep at the wheel and missed plowing into a tree by millimeters. (I have no signs of CYP2D6 deficiency.) While on the subject, do you know of the codeine "test" for 2D6 deficiency? If it provides no pain relief, that person is deficient in 2D6; codeine is a prodrug metabolized by 2D6, and only its metabolites provide analgesia.
>
> I'm no brainiac, but grapefruit juice with low dose selegiline seems worth trying, since it is known to inhibit metabolism of substances from caffeine to felodine to verapamil. If, with that mechanism, you can decrease your dosage of selegiline to 10mg/day, you can eventually restore its selectivity for MAO B. While ascertaining blood levels of various metabolites might be interesting, they may not have sufficient clinical utility to justify the costs--particularly if no further pheo testing is necessary.
>
> Good luck and well wishes---medlib
poster:Adam
thread:69963
URL: http://www.dr-bob.org/babble/20010809/msgs/74381.html