COMT/MAO issue

[LucyLouWho]

My doctor said I have this issue. A mutation. That I can have too much dopamine or something?

Also, I am extremely depressed and he wants to put me on Viibyrd. I read the side effects and they are itching, diarrhea and brain zaps. No way. The depression came on from going down on steroids. My brain chemistry is a mess but I think this drug would be awful for me as I have MCAS. I do not need itching.

What does one do for this mutation?

Misfit-

 

[Alvin]

I know nothing about this mutation but i do know neuroleptics are trouble. For ME/CFS patients your playing russian roulette (though some may disagree).

 

[LucyLouWho]

For ME/CFS patients your playing russian roulette (though some may disagree).

I was on Zyprexa for sleep. I had the worst withdrawal of my life and had to go live with a friend. I was lifeless. It did help me to sleep but I was flat lined.

This medicine Viibyrd is an SSRI.

 

[Alvin]

I was on Zyprexa for sleep. I had the worst withdrawal of my life and had to go live with a friend. I was lifeless. It did help me to sleep but I was flat lined.

This medicine Viibyrd is an SSRI.

When Prozac came out it was touted as a miracle drug, less side effects, non addictive and no withdrawal, all specific advantages over its predecessor class of antidepressants. Very little of this was true but it had no storied history yet and in many ways SSRIs have followed the same path, touted as excellent drugs which then become tarnished over time. But since the 90s advertising and medical malfeasance for profit have become more entrenched and its only when those doctors are retiring that the new generation learns the harms the previous generation of drugs cause (or when a new competitor comes out and spends lots of money to convince doctors to use it).
Easy answers are very appealing but often fall flat, and outdated knowledge is hard to kill, especially when there is billions of dollars trying to prevent patients and doctors from learning reality

 

[adambeyoncelowe]

I'm very wary of neuroleptics too. Similarly, most antidepressants don't seem to work for us too. I think neurotransmitter problems are probably downstream of other issues (neuroinflammation, for example).

I'm not sure what a good alternative is. It's ultimately up to you. Maybe you can find one that doesn't have the same side-effects?

 

[hedgehog]

I’m sorry, I don’t know about the mutation, but I’ve tried Viibryd. It sounds like you don’t plan to try it, but I think if you do try it, you should trust your gut about how low of a dose you would need with your sensitive system.

I let my doctor decide what was a low dose and slow titration, but I should’ve gone with my past experiences with medication. I think it might have caused serotonin syndrome and contributed to my me/cfs relapse. But that doesn’t mean it’ll be the same for someone else.

Medication is such a gamble for us. It’s a lot of trial and error, but I hope something that you can tolerate well comes your way

 

[Amw66]

My doctor said I have this issue. A mutation. That I can have too much dopamine or something?

Also, I am extremely depressed and he wants to put me on Viibyrd. I read the side effects and they are itching, diarrhea and brain zaps. No way. The depression came on from going down on steroids. My brain chemistry is a mess but I think this drug would be awful for me as I have MCAS. I do not need itching.

What does one do for this mutation?

Misfit-

What mutation do you have re COMT and MAO? These can affect many processes

 

[alicec]

What does one do for this mutation?

I suspect that your doctor is referring to the common COMT variant rs4680 AKA V158M. Approximately 50% of the population is +/- for this variant and 15-20% is +/+.

The variant does slow the function of the enzyme, whose normal role is the breakdown of dopamine and related neurotransmitters such as adrenaline and noradrenaline. It also breaks down some forms of estrogens and some drugs.

A slower enzyme means higher levels of dopamine and other neurotransmitters. This is neither a good nor a bad thing. Different sets of advantages and disadvantages are associated with the variant and wildtype enzymes.

Mutation is a misleading term and is usually reserved for rare genetic changes with serious consequences. This variant is widely preserved in the population presumably because it does confer some advantages. It certainly doesn't have serious adverse consequences.

It doesn't need "treating". Magnesium is the cofactor for the enzyme so ensuring you have an adequate supply will in turn ensure that the enzyme is not compromised by cofactor shortage.

There are other less studied COMT variants and variant combinations which affect enzyme activity. They are listed and discussed here.

With MAOA, again I presume that your doctor is referring to the common variant rs6323 AKA R297R. If s/he is saying that this variant affects the activity of the enzyme then I'm afraid s/he is wrong. There is a great deal of misinformation circulating about this variant, claiming that this SNP is the so-called "warrior" gene or is a proxy for it. None of these claims are correct.

The name of the variant tells you straight away that it doesn't amount to much. The arginine (R) at position 297 in the variant protein remains unchanged. In other words, the enzyme produced by the variant gene is identical to that produced by the wildtype gene.

Here here and here are a couple of posts giving more information. Unlike COMT, there are very few SNPs affecting this enzyme. Those that do are rare and result in very serious consequences.

You don't need to do anything about this SNP. It has no effect.

 

[LucyLouWho]

I’m sorry, I don’t know about the mutation, but I’ve tried Viibryd. It sounds like you don’t plan to try it, but I think if you do try it, you should trust your gut about how low of a dose you would need with your sensitive system.

Hedge, I am on Viibryd. Only 5 mg. I am feeling so much better mentally. It's like I am out of outer space. I agree that my issue is coming from neuro inflammation. Whoever said that is spot on. My sleep has been affected though, but anymore I am not sure what is doing what since I have so many issues and perimeno and then also having so much pain and MCAS. it's all one big web. I can't stand it.