Genetics and benzos

[[Le...]]

I'm sure it's a very complicated situation. There are so many factors, e.g. which medication, what dosage, for how long, any other medication, alcohol, liver and kidney function, age, general health issues, etc., etc. Perhaps some day, all of this will be much clearer.

Thank you Lapis. Your explanation is spot on...makes more sense than mine.

[[La...]]

Ah, you're welcome, LB! In some of the studies I've read, they mention such things. One of the studies looked at the cumulative effect of a senior taking a long-acting benzo over a period of time. It required a complicated calculation, and in the end, it showed there was, indeed, a cumulative effect over time. Seniors metabolize things more slowly, so it's something that needs to be taken into consideration.

 

Those of us tapering or already off these medications want nice, neat answers to our questions, but the truth is, we just can't have them now. Pharmacogenetics might provide a bit more information, once it becomes more widely used. Maybe some of the medication errors can be avoided. And maybe tapering off various meds will be easier too. I really, REALLY hope so.

 

I do feel somewhat lucky, however, that it's 2016 and not 1980-something, because we, at least, have a lot more info than those poor souls did 30 years ago. They were really in the dark.

[[Le...]]

You're right, the science isn't there yet..one day, but not now. I must admit I find it all rather fascinating. The liver enzymes are only the tip of the iceberg. I look forward to the day when epigenetics is foundation upon which medication decisions are made. Well, I may not live to see that happen. And, yes I'm grateful that it's not the 1980's. Thanks again Lapis for sharing your knowledge.

[[La...]]

Have a look at Table 1 on Page 15 of this excellent NYC Health Information brochure. It refers to the interaction between benzodiazepines and different types of medications. For instance, it refers to the CYP450 effect, i.e. "increased serum benzodiazepine levels" when they're combined with SSRIs such as fluoxetine (Prozac) and paroxetine (Paxil), among other types of medications.

 

Yes, I took Prozac and benzodiazepines at the same time. I can't believe I wasn't warned of the interaction. I only found out about it after the fact.

 

Anyway, it's a great brochure, so you might want to print it out and share it with your doctors, other medical professionals, family members or friends.

 

http://www1.nyc.gov/assets/doh/downloads/pdf/chi/chi-35-2.pdf

[[Le...]]

Very interesting Lapis. SSRIs didn't work for me either. Combining them with benzos caused more problems for me too.

 

I developed sleep paralysis and hypnagogic hallucinations when I took Prozac and Xanax together. I was so doped up on the Xanax that I was constantly falling asleep. The pdoc was certain I had narcolepsy. I tested "positive" on the sleep study so amphetamines were added to my long list of meds. What a mess! As soon as I stopped the Prozac the sleep paralysis and hypnagogic hallucinations stopped. It was a drug interaction... never had a sleep disorder. 

 

Over a decade later, I finally had genetic testing... Surprise, surprise, none of the antidepressant classes work with my genetic makeup (both liver enzymes and actual genetic anomalies). There are numerous classes of medication that I don't metabolize normally.  I should probably look into getting a med alert bracelet.

 

Left 

 

 

[[La...]]

Wow, Left Behind! It's great that you eventually had the appropriate testing, but I'm so sorry you went through all of that. Can you imagine the numbers for whom these meds are problematic? Must be huge.

 

I think a MedicAlert bracelet might be a good idea. You could save yourself from any indavertent medication errors.