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Testing for levels of CYP2D6?

Dante

Dante

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Oct 30, 2001
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It's always been mentioned that people with low levels of CYP2D6 (the liver enzyme that breaks down both DXM and MDMA) can have complications to do with the consumption of either of these...
Is there any simple way to test for levels of CYP2D6 at all, or is there any way to specifically ask for testing to be done?
 
What a bloody good question, I'm not sure if I've seen someone ask this before. Perhaps this is one for the Health Q&A forum?
 
Well, one *very* approximate test would be whether a person has problems urinating or not while pilling.
If they normally have a problem going to the toilet when pilling, that *should in theory* suggest that the enzyme is working normally in their system.
Like I said, very approximate, but the simplest test I can think of. I'm sure that babydoc and BT will be able to talk more about this.
 
OK... remembered whah made me think of that.
From New Scientist 22/4/02 - "Ecstacy- How Dangerous is it really?"
Research is now under way to discover the underlying factors that make different people react to ecstasy in different ways. The way the body metabolises the drug is likely to be crucial. For example, the liver enzyme CYP2D6 that helps break MDMA down is inactive in up to 1 in 10 people of European descent, which could make them especially sensitive to some of the drug's effects.
Confusingly, it might also protect them from others. The complication is that some of MDMA's effects are caused not by the drug but by its breakdown products. Henry's team has preliminary evidence from rats to suggest that one of these, called HMMA, is better than MDMA at provoking the brain to release antidiuretic hormone. If confirmed, it could mean that people who break down MDMA rapidly are more at risk of hyponatraemia. Claire Ainsworth
So an extremely rough test would be, in theory, if youre the type to get incredible mashed every time and have little trouble urinating.
*shrug*
Click to expand...
 
So if you think you are in this catagory of inactive liver enzymes, what precautions should be taken?
[ 25 April 2002: Message edited by: porn* ]
 
I know this type of testing can be done in USA, but I am not aware of it being done here. See People Screen for one such service. Certainly, in the past it was felt that CYP2D6 deficiency could lead to problems for MDMA users, but recent evidence suggests it may not be so simple.
People can be deficient in CYP 2D6 either naturally or from taking certain medications, or they can have normal amounts, or they can have large amounts. It appears that people with large amounts may be more at risk than those who are deficient, as per the New Scientist quote, and this recent discussion from this forum: Ecstasy LD50 question In particular, I'll quote this again:
In fact, it was recently shown
for the first time that three patients with fatal MDMA intoxication were all extensive metabolizers (note that PM = poor metabolizer in that paper).
One way that you could do a home test for CYP2D6 function, (not that I'm recommending this or anything) would be to take some plain codeine if you have it for pain. If it doesn't relieve the pain, you may be deficient. Codeine needs to be activated into morphine by CYP2D6 to relieve pain.
porn*: if you thought you were CYP2D6, I'm thinking you would want to take low dosages of MDMA. You would need to be particularly careful about avoiding medications that inhibit the other enzymes that break MDMA down like CYP3A4. You can see some medications that fit into this category at Cytochrome P450 Drug Interactions.
Could a Mod maybe put this thread in Health as well as here please?
[ 25 April 2002: Message edited by: babydoc_vic ]
Click to expand...
 
*porn, another thing to do if you were deficient in the enzyme would be to drink less water. Because you are not pissing out the water, the only way it can leave the body is via sweating, thus only about 500mL an hour would be recommended, any more and hyponatremia may be a reality. Due also to the smaller amount of water being consumed, sadly you'd have to not go as hard.
By the way,
Hyponatremia = lack of enough sodium in blood = BAD = possible death.
 
The passage I posted above from New Scientist would suggest that you would actually be able to drink more water if you were deficient in the enzyme.
 
Hmmm very intresting. Must say that this is a great question to ask. A nice change from the usual ones!!
 
It's all well and good to test using DXM and codiene if you are looking for low levels of CYP2D6, but what if you were testing for a higher level of CYP2D6?
That's what I'm most interested in, because it could explain why some people need higher dosages of DXM and MDMA to be affected properly...
Any comments?
 
Jakoz, I read the same article... (I got me a lifetime subscription :) )
Because there is no other way to get rid of the water because of the trouble urinating, there would be a build up of water if you were to drink more. And that's what would cause problems.
 
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