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Q: I have G6PD enzyme deficiency. As far as i know, it is a common enzyme deficiency. Some substances may cause hemolytic anemia if taken. Could you please inform me which drugs I should avoid? I am most intrested in entheogens such as mushrooms, LSD, and Ecstasy.

A: This is a very good question. First, let me point out that I am not a doctor and nothing in Ask Erowid should be considered medical advice. There are serious health risks when taking many strong psychoactives and unusual enzyme deficiencies could certainly lead to unusual reactions.



The issue of differences in metabolism between individuals and enzyme systems is of increasing interest to those researching the effects of medicines over the past decade, as techniques for diagnosing these deficiencies become better established. While I am not aware of any research which directly addresses your question, there is research showing a wide variation in metabolisis of MDMA (ecstasy) between individuals and there is speculation that this may be due to different levels of certain enzymes used to break down the chemical in the blood and liver.



As you know, the G6PD enzyme deficiency is perhaps the most common enzyme deficiency known, with as mucy as 10% of the world's population 'deficient' (Scriver et al., 1995). This deficiency, occasionally called "Favaism" since it is often first noticed when an individual gets sick from eating fava-beans, causes certain chemicals not to be metabolized normally.



An excellent introduction to this topic is at the Favism Homepage which has a list of medications which are contra-indicated and which are considered safe to take if you have this deficiency.



There is no way to know if something is 'safe' to take, since there are always risks with any medicine, drug, or food. Perhaps the only way to approach the problem of which psychoactives might be most problematic is to look for similarities in chemistry and metabolism between the psychoactive in question and the lists of medications which have been studied in people with G6PD deficiency. From scanning the lists of contraindicated medications available on the web, I don't see anything related to LSD, psilocybin, or MDMA that is clearly contraindicated or considered OK, which doesn't tell us much.



After searching PubMed for the terms "G6PD" and either "deficient" or "deficiency" with the drugs "amphetamine", "opiate", "codeine", and "cocaine" (those substances most likely to have been studied in lab research) and came up with no results at all for any of those searches. So this also doesn't tell us much.



The next step would be to talk to a G6PD specialist and talk to them about contraindicated medications. Amphetamines, ritalin, and the like are commonly prescribed for depression and ADD and have some similarity in metabolism with ecstasy. Opiate painkillers such as codeine and hydrocodone are prescribed for acute pain (dental work, injuries, etc). Some lysergic acid compounds are used in treating migraines. I don't know of any medications which are similar in metabolism to psilocybin, so I wouldn't know how to research potentially similar medications. A specialist might be able to find references which would discuss negative reactions to these substances.



A recently published article, Pharmacol Res 2001 Jul;44(1):7-11, suggests melatonin has the ability to upregulate G6PD. "Effects of melatonin on enzyme activities of glucose-6-phosphate dehydrogenase from human erythrocytes in vitro and from rat erythrocytes in vivo." by Ciftci M, Bilici D, Kufrevioglu OI.



The findings indicate that melatonin may be pharmacologically useful in patients where a deficiency of the enzyme in red blood cells (RBC) causes haemolytic anaemia. The paper basically says that millimolar amounts of melatonin, approximately 60uM to 80uM, is effective at increasing levels of G6PD enzyme.



The paper's abstract can be found it at PubMed



Please be very careful when experimenting with new psychoactives and consult your physician before self medicating.



Asked By : shaman_anarchist
Answered By : Freeblood
Published Date : 11 / 30 / 2001
Last Edited Date : 11 / 30 / 2001
Question ID : 2904

Categories: [ Health ]



Ask Erowid v1.7 - Jul, 2005

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