Personally, Id be wary of any prescriber who is not willing to discuss. Often more quickly than 10 years, though. Currently, pharmacotherapy for the treatment of ADHD is divided into two classes: Of these medications, methylphenidate has been the most frequently dispensed, while atomoxetine prescriptions peaked in 2004 and have since experienced a statistically significant downward trend. Thank you and your husband for providing this much needed venue for those with and impacted by ADHD. Plus, my physician at the time prescribed 300 mg right off the bat. Drug Topics. And that this prescriber ordered the testing? Genet 1989;45:889-904. This series has been great Gina and has gotten a good response on the A Moms View of ADHD FB page when I have shared them. I think Genesight actually does offer the test. Hanioka N, Kimura S, Meyer UA et al. Now that we have summarized the main effects of genetic polymorphisms on Characterization This series had such great information! Boo, another semi-crappy genotype. May experience side effects at standard doses. Everytime I think I have moved toward normal in some way it isnt long before I am reminded or realize my improvement is a cut off a cartload compared to the work remaining. But I am tired. There are lots of enzymes in humans, but here's a particularly significant one when it comes to drug-response: Cytochrome P450 2D6, an enzyme encoded by the CYP2D6 gene. CYP2D6 is among the most promiscuous of these enzymes, involved in the metabolism. Differences in your DNA that make up the CYP2D6 gene can affect how well you are able to break down certain medicines. debrisoquine: study of the functional significance of individual Steen VM, Molven A, Aarskog NK et al. The drug classes that I just recently stumbled upon your blogs, and have been glued to my email for the latest posts! In addition, this enzyme also metabolizes dopamine and serotonin. But it neednt be. . My husband has had very little success with medication, but has only tried one or two of them. As I said before, we all have semi-crappy genes. What are Gaedigk A, Blum M, Gaedigk R et al. Furthermore, some medication substrates of CYP2D6 may require This test looks only at the patients genotype and its relationship to these drugs. So the plan for this patient, and there are other options out there as well, but just . Thanks for the insight, Griese EU, Asante-Poku S, Ofori-Adjei D et al. . or reduced enzyme activity, any medication that is a substrate for metabolism I would love to be able to test my Ninja Boy! The CYP2D6 gene is a section of DNA that instructs how well CYP2D6 enzymes will work. Keep up the great work! Patientswho are poor metabolizers (individuals with no CYP2D6 activity) or ultrarapid metabolizers (individuals with genetically elevated CYP2D6 activity) can have markedly altered response to drugs that are CYP2D6 substrates. 1994;3:923-926. I was wondering if you may help me understand whether, in your opinion, you think trying an alternative medication (I am thinking Strattera?) These posts have been very interesting and informative! Vyvanse contains dexedrine. PW Pharmacogenet Newsl 2010;2(43):171-175. I really learned something new here. gene defect at the cytochrome P450 CYP2D locus. CYP2D6 can result in a reduced analgesic effect if either one of these two Are there any CYP2D6 poor metabolizers out there successfully using Vyvanse? Seems like the whole world is more concerned with the drug abusers then the people who truly benefit from this type of medication, myself being one of them. MPH Ritalin, Concerta, Daytrana, etc. The CYP2D6 substrates making up the Pharmacogenomic testing can help providers to prescribe medications and doses that are safe and effective, at times achieving the positive clinical outcomes with minimal side effects. As I previously mentioned, I did try it years ago, but only after I was already taking a stimulantand starting at too high a dose. antihypertensives (specifically the beta-blockers) and antiarrhythmics. Pharmacogenetics 1999;9:715-23. Youre saying that the genetic testing indicated that Vyvanse, Risperdal, and Adderall are the choices for you? But I was already taking one of these. Touch device users, explore by touch or with swipe gestures. We do not endorse non-Cleveland Clinic products or services Policy. CYP2C9 is an enzyme that is responsible for breaking down (metabolizing) several of the drugs that are commonly used today. If you read about my husbands test results, he had only one Rx in the green category: Wellbutrin. The first of these are Hi Gina, Very important info!! Gina Pera is an internationally recognized author, speaker, and educator on Adult ADHD, especially as it can affect relationships. Maybe a chart of some kind. Given that the majority of genetic polymorphisms to CYP2D6 result in absent They are partnered with Rite Aid and the roll-out on the west coast will be implemented in the next few weeks. My hubby has been experimenting for 10 years now, but is interested in what the DNA might suggest. Doctors should take all of this into account when prescribing medications. However, patients with CYP2D6 intermediate and poor metabolizer status had increased numbers of pain-related hospitalizations and more frequently required the potent non-CYP2D6 opioids morphine and hydromorphone. causing reduced catalytic activity. But is this the best way to identify optimal medication? My therapy office is trying to use this to say that you are or are not ADHD. Helpful ADD information is so hard to find, we will consider giving this a try. Your email address will not be published. Here are the guidance notes for this particular menu: 1 Patients with this genotype are less likely to respond to alpha-2 adrenergic receptor agonists [e.g. population: association with diminished debrisoquine hydroxylase Call your physician or care team for medical advice. My son Matt is 22 years young and hes been inundated with ADHD for several years. Thus, genetics, rather than drug therapy, accounts for most ultrarapid CYP2D6 metabolizers. First, I tried Ritalin modified release but had too much anxiety in general to get to a decent dosage. Hes kinda burned out on hearing about his condition and has doubts in a successful treatment. Your email address will not be published. They should be given trials of each. greatest risk for being a CYP2D6 poor metabolizer include African Expert: Infusion Pharmacy Technicians Can Reduce Workload in Oncology Pharmacy, Clinical Forum Recap Data Show Melanoma Site to Be Independent High-Risk Factor for Recurrence, Poor Outcomes, Beverly Hills Pharmacy—Pharmacy to the (Sports) Stars, CCPA Speaks Out: Pharmacy Awaits Outcome of Key Legislation, New Tiered Copays Pricing Patients Out of Treatment. That is, identifying a medication that is likely to work for your son and then checking the FDA-mandated label material (the sheet of tiny print, which you can also find online). I learned this yesterday from Harmonyx. Cytochrome P450 (P450) 2D6 is a major drug-metabolizing enzyme expressed in the liver 1. for being a CYP2D6 poor metabolizer include African Americans/Black Drugs metabolized by CYP2D6 arecalled CYP2D6 substrates (see Table 2 at right). Summaries of summaries of summaries! If you have my first book, I explain the differences between Adderall and the other stimulants. Will you respond well to it? , I bet the Strattera was at a high dose? When considering half-life and area under the curve (AUC) of atomoxetine in CYP2D6 extensive metabolizers, patients with this phenotype are likely to respond to atomoxetine, but may require doses at the higher end of the recommended range. Cytochrome P450 2C19, known as CYP2C19, enzymes break down several commonly used medicines. Drug Metab These include, but are not limited to, carboxylase easterase 1 (CES1), cytochrome P450 2D6 (CYP2D6), dopamine receptor D1-5 (DRD1-5), adrenoceptor alpha 2A (ADRA2A), catechol-O-methyl-transferase (COMT). affect the central nervous system (CNS). Rapid metabolism? Thank you, That aside, I dont know what medication to attempt (as there are so many) and hoping you or your husband may provide your two cents on the matter. Sometimes Adderall works well for a person, in terms of sort of propelling them through the day. Harmonyx says the kit will be available on the West Coast soon, through Rite-Aid stores. About 0%-14% of the population, depending on geographical origin, 10 is made up of CYP2D6 poor metabolizers, and these patients may have high levels of venlafaxine even before starting bupropion treatment. I get that dosing varies outcomes but Im desperate for my son to get meds without continued damage to his liver and these doctors have no idea what Im talking about when I ask them the pharmacokinetics of what is being prescribed. Then I tried Strattera. Resulting phenotype: Normal(Extensive)-to-ultra-rapid-metabolizer Goat riding his High Horse. First, regardless of CYP2D6 metabolizer status, you want to know that those three medications are necessary and represent methodical treatment not just throwing spaghetti at the wall. The genetics of CYP2D6 has been extensively studied, and individuals can be divided into 4 groups. When subjects have at least three active copies of the CYP2D6 gene, they are called ultrarapid metabolizers (UMs) and present high metabolic capacity for CYP2D6 substrates. Poor Metabolizer (PM) - This means there are two copies of low or no activity genes. Poor metabolism can block the breakdown of a medication or prevent it from being assimilated. Its possible to over-feed that machine, at which point bad things can happen. For example, most tricyclic antidepressants undergo CYP2D6 metabolism, but other CYP450 enzymes also may be involved. The connection between CYP2D6 and Vyvanse doesn't seem to be as clear as other amphetamine type drugs like Adderall. of the CYP2D6*29 allele commonly present in a black Tanzanian population dextromethorphan, dolasetron, ondansetron, ritonavir, tamoxifen, and Patients who have little CYP2D6 activity, therefore, are likely to have little response to codeine. Experimentations can be very disruptive personally and professionally, so I am reluctant to mess around with what seems to be working. What were you hoping to learn? Pharmacogenomics the study of how an individuals genetic variations impact the response to drugs has emerged as an essential tool to optimize therapy and minimize the risk of adverse effects. She tried brand/authorized-generic Concerta? Harmonyx I believe, as well as tests a doc would order, will look at pertinent polymorphisms and copy number variants. Clin Pharmacol 2000;50:31-4. Also: Has your life started demanding more of you in the way of Executive Functions? I think riding the medication roller coaster is one of the most frustrating parts of parenting a child with ADHD. The interesting thing is that bupropion (Wellbutrin) might be a useful medication for me after all. If you break down a medicine too fast or too slow, the medicine may not work as well, or you may have more side effects. Despite adjustments for age, weight, concomitant medications, and renal or hepatic function, certain patients respond well to medications, some experience severe adverse effects, while others do not respond at all. The Together Community is a place where anyone affected by pediatric cancer can connect and support one another. As a summary of the main genetic polymorphisms of cytochrome P450 (CYP) 2D6 and I wonder if it might also indicate an age group? There you have it, folks! Thank you. Growing evidence suggests that breast cancer patients with low CYP2D6 activity do not respond as well to tamoxifen therapy and are more likely to have cancer relapse. Prozac, Paxil and Antihistamine Interact With Amphetamines [AMP] Through CYP 450-2D6. would be beneficial. Frequencies of CYP2D6 Does that mean that the test is wrong? CYP2D6 is likely to result in elevated plasma concentrations which can further Hi Gina, But there are a ton of exceptions. Margaret. Im not sure what your therapy office is aiming for, but there is NO genetic test for ADHD. I seriously enjoyed reading it, you may be a great author.I will be sure to bookmark your blog and may come back down the road. metabolism via CYP2D6 to their active forms (which is morphine for codeine and A pharmacogenomic test looks for differences that can help your medical team know how well your CYP2D6 enzyme will work. Oh, thanks, Lattegirl! cytochrome P450 CYP2D6 gene as a cause of impaired drug metabolism in A family of enzymes called cytochrome P450 breaks down certain medicines. Importantly, however, more studies, with much larger sample sizes, are needed before we can be certain that the cost-to-benefit scales tip in the favor of pharmacogenomic testing for ADHD medications. Any thoughts on ADHD meds that might work for a CYP2D6 Ultra-Rapid Metabolizer? is it safe to take tylenol after a stroke is it safe to take tylenol after a stroke The number of people with low CYP2D6 activity is substantial, when one considers the people genetically deficient in CYP2D6, plus the many patients who are taking CYP2D6 inhibitors. Are there any supplements that would be helpful? variant CYP2D6 allele with a single base deletion in exon 3 and its 2 Patients with this genotype are less likely to respond to the amphetamines. A decent genotype for once! Br J So, a stimulant with low-dose Concerta or an antidepressant.thats pretty typical. Because the Concerta generics dont work as Concerta goes. This can be interpreted as competitive inhibition, suggesting that diphenhydramine may be a CYP2D6 substrate. Why are you disappointed? There is an expression in the medical diagnosis field: Think horses, not zebras. There is growing consensus on the potential use of pharmacogenetics in clinical practice, and hopes have been expressed for application to the improvement of global health. Thats much lower than the stimulants. 5 Extensive metabolizers may show appropriate response to atomoxetine at the higher end of the recommended dose range. In psychiatry, CYP2D6 and CYP2C19 are important drug-metabolizing enzymes 3, 4, 5, 6, 7, 8. In particular, the studies examining the variant-drug combinations with stimulants is lacking clear evidence of an association or have not been replicated. Multiple mutations of the These are the Several genetic variants are being studied in regards to therapeutic response to ADHD medications. metabolizer"); 3) The two patient populations that are likely at the Insane. Then I was put on Concerta a year later with 72 mg having no effect except depression and high pulse rate. Very interesting series. Oh well. [ ref] Alternatively, pro-drugs, such as Plavix, convert into their active drug state through CYP2C19. Note: CYP2D6 inhibitors may decrease the drug's efficacy. I also respond very little to codeine, and my tolerance goes through the roof after 3 days. ADHD Medications Pharmacokinetics & Pharmacodynamics, Genetic Testing for ADHD medications: Overview, https://www.ncbi.nlm.nih.gov/books/NBK315951/, ADHD, DNA, and Predicting Medication Response: Part 1 - ADHD Roller Coaster with Gina Pera. And remember: this is only as far as this particular gene is concerned (there are many other factors beyond this one gene!). antihypertensives and specifically the beta-blockers. For a comprehensive list of medications substrates common genetic polymorphisms to cytochrome P450 (CYP) 2D6 that could Results: At endpoint, poor metabolizers had markedly greater reductions in mean symptom severity scores compared with extensive metabolizers (less than 0.05). The CYP2D6 (sounds like "sip-2-dee-6") gene encodes an enzyme that is involved in the metabolism of ondansetron. Her mission for 20 years has been empowering adults with ADHD and their loved onesand raising the standard of care through her books, blog, presentations, and now online education. Might be worth a try. As Im sure you know, Harmonyx is not currently active. I appreciate the scientific detailed and current information presented in a professional manner. Do you mean genetic markers? I would also have to take into account any other drug I might be taking. This may reflect inadequate initial analgesia with the common "first-line" CYP2D6-metabolized opioids. When you take a medicine, your body needs a way to handle it. Not Intuniv and certainly not Zoloft (an SSRI). . 2001;11:417-27. I would be thrilled to find out my boys genotype, to help in future decision making when it comes to his meds. I am learning so much from this. It breaks down about a quarter of all drugs, including: Antidepressants such as Prozac Breast Cancer (Tamoxifen) Antipsychotics (e.g. Mainly because you wrote: dextroamphetamine=Adderall XR. If not, there are tests that your MD can order, such as through Genesite. The CYP450 enzyme CYP2D6 is involved in many important drug interactions. The human debrisoquine Treatment targets. Nature and propoxyphene). human cytochrome P450IID6 gene (CYP2D6) in poor metabolizers of Specific guidelines, there is an alternative, so atomoxetine can also be used for ADHD. The drug classes that appear to be impacted most are the 4 Use with monitoring. This patient is homozygous for the C allele of the 1291G>C polymorphism in the adrenergic alpha-2A receptor gene, which decreases binding affinity at the alpha-2A receptors. Lastly, the other If you print or download this or any content, you should check back after 72 hours to make sure it has not changed. ADHD in adults with the comorbid partially responsive major depressive disorder . Advertising on our site helps support our mission. I did not even realize such tests existed. For various reasons. The majority of literature regarding equine drug metabolite profiles is derived from sports drug detection research and is generally targeted at . Your or your childs appropriate treatment relies upon being a smart consumer. Thats why she created this soup-to-nuts online courseon ADHD-related sleep issues and medication. It happens ALL the time. In previous issues of Pharmacy Times we have discussed the cytochrome P450 (CYP450) enzymes CYP1A2,CYP2C9, and CYP2C19. I told her doctor I didnt want that med, but my insurance wouldnt pay for the Vyvanse and thats what she got. Is it possible that you are entering peri-menopause or menopause? Of these genes, CYP2D6 has more than 100 allelic variants that have been defined and can be characterized as normal function, decreased function, or no function. used in clinical practice that may be affected. May have too much medication at standard doses, potentially causing side effects. As such, it reduces the effectiveness of this receptors interactions with a number of stimulant drugs as well as the alpha-2 adrenergic receptor agonists (e.g. Remember post 4? The genetic variation increases the plasma concentration of atomoxetine and thereby the risk of side effects. of clinical relevance since 34% of the listed medications also represent Especially if its not covered by insurance and money is tight. (more commonly opioid analgesics). appear to be impacted most are the psychotropics and/or medications known to But when life gets more complicated, and they havent steadily been developing supportive habits, Adderall taps out. decreased function of the enzyme activity (i.e., being a "poor Do you know of any other companies right now that do??? Adderall was a problem 20 years ago, and its still a problem! Generally speaking, being a poor metabolizer means you will need a higher-than-average dose of the medication in question. For example, maybe youve tried a methylphenidate stimulant and just didnt mention it. It would be a lot easier with some sort of guide, such as harmonyx. Thanks for explaining all that to us. The CYP2D6*1 is considered the wild-type allele when no variants are detected and is associated with normal enzyme activity and the "normal metabolizer . The two patient populations that are likely at the greatest risk About 40% of people with ADHD do clearly better on one class of stimulants than the other (MPH vs AMP). I havent tried any immediate release, just XR. Sorry youre having such trouble. That is useful information. I think it may give his doctor a better idea of what medication to try first, rather than guessing. She tried Concerta as well up to 36mg and it did nothing. Lets review the printed information on the first gene, and Ill follow with a translation. Not at all. The Together Blog is a resource that delivers timely topics on childhood cancer from providers, families, patients. Because Id want to know sleep status, diet, generic vs. brand, delivery system, stimulant class, and a lot more. Yes, it can be overwhelming. That is, not explain the reasoning. I had a severe adverse reaction to wellbutrin which prompted a genetic testing (my nearly 8th failure at an antidepressant and/or anxiety med) where like your husband I did not win the genetic lottery! Although the author does her best to provide sound and useful information, she cannot and does not promise beneficial results to anyone who may use that information; nor does the author accept liability to anyone who may use the information. References: CYP2D6 Genetic Polymorphisms, Medication Substrates of CYP2D6, Submit a CommentSubmit a TopicHow to Expand RefHow to Search, Submit a Comment | Submit a Topic | How to Search. Especially with women. Just for fun, lets look at one more of my genes: Prevalence: 48% African Americans, 25% Asians, 38% of Caucasians. What does this mean? pharmacologic effects. Says the kit will be available on the first of these are the 4 use with monitoring,... This means there are other options out there as well up to 36mg and did... Any other drug I might be taking latest posts is wrong will at... Pharmacogenet Newsl 2010 ; 2 cyp2d6 poor metabolizer adhd 43 ):171-175 CYP450 enzymes also may be useful! And its still a problem ADHD in adults with the common & quot ; opioids... An internationally recognized author, speaker, and CYP2C19 harmonyx is not active! Drug metabolite profiles is derived from sports drug detection research and is generally targeted.... And serotonin Ultra-Rapid Metabolizer all have semi-crappy genes not been replicated generally targeted at are or are not ADHD ADHD... Have not been replicated through CYP2C19 Together Community is a section of that. Not zebras that mean that the genetic testing indicated that Vyvanse, Risperdal and... And CYP2C19 are important drug-metabolizing enzymes 3, 4, 5, 6, 7,.! Instructs how well you are or are not ADHD most ultrarapid CYP2D6 metabolizers had too much medication at standard,. Pulse rate can happen differences in your DNA that instructs how well CYP2D6 will. Riding his high Horse in regards to therapeutic response to atomoxetine at the Insane metabolizers may show appropriate to. Be a CYP2D6 Ultra-Rapid Metabolizer sleep issues and medication genetics of CYP2D6 Does that mean that the test wrong! That Vyvanse, Risperdal, and educator on Adult ADHD, especially as it can affect relationships dose.... To use this to say that you are able to break down several commonly used medicines manner., patients a smart consumer 3, 4, 5, 6,,! Been inundated with ADHD for several years drug detection research and is generally targeted at to find, we consider. ( Wellbutrin ) might be a lot easier with some sort of guide, such as through Genesite high. Delivers timely topics on childhood cancer from providers, families, patients which. Dopamine and serotonin test looks only at the patients genotype and its still a problem 20 years ago, Ill. Son Matt is 22 years young and hes been inundated with ADHD need higher-than-average! Maybe youve tried a methylphenidate stimulant and just didnt mention it several years therapy accounts... A cause of impaired drug metabolism in a professional manner through CYP 450-2D6 not, there are two of... Very disruptive personally and professionally, so I am reluctant to mess around with seems... ) ; 3 ) the two patient populations that are commonly used today ; 3 ) two! Discussed the cytochrome P450 breaks down about a quarter of all drugs, including: antidepressants such as Breast..., diet, generic vs. brand, delivery system, stimulant class, and a lot easier with sort... Most are the 4 use with monitoring that you are or are not ADHD, 8 for I! Affect relationships your husband for providing this much needed venue for those with and impacted by ADHD be as. Examining the variant-drug combinations with stimulants is lacking clear evidence of an association or have been. There are two copies of low cyp2d6 poor metabolizer adhd no activity genes care team for medical advice to get a... Targeted at detailed and current information presented in a professional manner the genetic variation increases the plasma of!, Kimura S, Ofori-Adjei D et al the West Coast soon, through Rite-Aid stores 7! Any thoughts on ADHD meds that might work for a CYP2D6 Ultra-Rapid?. Of genetic polymorphisms on Characterization this series had such great information it nothing... Have semi-crappy genes make up the CYP2D6 gene is a substrate for metabolism I would love be! The genetic variation increases the plasma concentration of atomoxetine and thereby the risk of effects. A resource that delivers timely topics on childhood cancer from providers, families, patients end. And support one another most promiscuous of these enzymes, involved in many important drug interactions she got enzyme is... The Strattera was at a high dose have my first book, I tried Ritalin modified release but had much. Dose of the these are the 4 use with monitoring studied in regards to response! It from being assimilated high dose of what medication to try first, I tried Ritalin modified cyp2d6 poor metabolizer adhd... It breaks down certain medicines you know, harmonyx is not willing to discuss Paxil and Interact! Doctor a better idea of what medication to try first, I explain the differences between Adderall and the stimulants. Is aiming for, but has only tried one or two of them any medication that a... Would be thrilled to find out my boys genotype, to help in future decision making when it comes his. A useful medication for me after all be available on the West Coast soon, through Rite-Aid stores test... Covered by insurance and money is tight has only tried one or of! Of CYP2D6 has been extensively studied, and my tolerance goes through the roof after 3 days prescribed. Seems to be impacted most are the several genetic variants are being studied in to. The 4 use with monitoring two of them with swipe gestures partially responsive major depressive disorder you. Treatment relies upon being a poor Metabolizer means you will need a higher-than-average dose of most. Latest posts except depression and high pulse rate giving this a try years. Cyp1A2, cyp2c9, and a lot more horses, not zebras anxiety!, Blum M, Gaedigk R et al several commonly used medicines Metabolizer '' ) ; 3 the. Up the CYP2D6 gene can affect relationships maybe youve tried a methylphenidate stimulant and didnt. Vyvanse and thats what she got regards to therapeutic response to atomoxetine at the Insane we have summarized main! Identify optimal medication enzymes break down several commonly used today harmonyx is not willing to.. Was at a high dose not, there are other options out there as well but! Disruptive personally and professionally, so I am reluctant to mess around with seems... A translation ):171-175 has your life started demanding more of you in the green category: Wellbutrin may... Their active drug state through CYP2C19 competitive inhibition, suggesting that diphenhydramine may be.! Into account any other drug I might be taking not Zoloft ( an SSRI.. My husbands test results, he had only one Rx in the green category Wellbutrin! With a translation internationally recognized author, speaker, and individuals can be divided into 4 groups a manner! Are likely at the higher end of the these are Hi Gina, but just first book, I the... With diminished debrisoquine hydroxylase Call your physician or care team for medical advice to... Clear evidence of an association or have not been replicated off the bat into account any other drug might. With 72 mg having no effect except depression and high pulse rate with a.! Important drug interactions mg right off the bat # x27 ; t seem to able! Ill follow with a translation works well for a person, in terms of of..., the studies examining the variant-drug combinations with stimulants is lacking clear evidence of an association or have been... With monitoring enzymes, involved in the way of Executive Functions information is so hard to find, will. Metabolizer ( PM ) - this means there are a ton of exceptions device users, explore by or! With stimulants is lacking clear evidence of an association or have not replicated! Of propelling them through the day of CYP2D6 has been extensively studied, and its relationship these! Topics on childhood cancer from providers, families, patients any other drug might. Which can further Hi Gina, very important info! only tried one or two of.. Note: CYP2D6 inhibitors may decrease the drug & # x27 ; t to! Profiles is derived from sports drug detection research and is generally targeted at best way identify! This patient, and a lot more a higher-than-average dose of the recommended dose.. 34 % of the medication roller coaster is one of the listed medications also represent especially if its not by! Blum M, Gaedigk R et al you know, harmonyx is not active... Other stimulants Vyvanse, Risperdal, and have been glued to my email for the posts... 7, 8 how well you are entering peri-menopause or menopause pediatric cancer can connect and support one.... Important drug interactions information is so hard to find out my boys genotype to... Frequencies of CYP2D6 may require this test looks only at the higher end of the recommended dose range or childs... Meds that might work for a person, in terms of sort of guide, such as through Genesite test! Of parenting a child with ADHD for several years to 36mg and it did.... To break down certain medicines my tolerance goes through the day did nothing information is so to... In elevated plasma concentrations which can further Hi Gina, but other enzymes. Higher end of the listed medications also represent especially if its not covered by insurance and is. Medications also represent especially if its not covered by insurance and money is.... And professionally, so I am reluctant to mess around with what seems to be as clear as other type. Be able to test my Ninja Boy husband has had very little to codeine, Adderall. But has only tried one or two of them a CYP2D6 Ultra-Rapid Metabolizer and Adderall are the several genetic are! Clear as other amphetamine type drugs like Adderall is responsible for breaking down metabolizing... Not Zoloft ( an SSRI ) are likely at the higher end of the listed medications also especially.