Posted by Tomatheus on December 1, 2006, at 0:39:06
In reply to L-tryptophan and Cymbalta?, posted by verne on November 26, 2006, at 20:13:12
> I just discovered that L-tryptophan and St John's Wort are on Cymbalta's drug interaction list.
>
> Does anyone know why these two would pose a problem while taking cymbalta?Verne,
My guess is that it's because of the potential risk of serotonin syndrome that could emerge as a result of combining Cymbalta with l-tryptophan or St. John's Wort.
L-tryptophan supplements carry warnings cautioning consumers not to combine the product with SSRIs or MAOIs for this reason. Cymbalta is not technically classified as an SSRI (it's an SNRI, formerly known as an SSNRI), but its potential to induce serotonin syndrome when combining it with l-tryptophan is probably comparable to that of the SSRIs due to the fact that it inhibits the reuptake of serotonin.
St. John's Wort is believed to inhibit the reuptake of serotonin, which could also conceivably cause serotonin syndrome if taken with an SSRI or SNRI (or any serotogenic medication, for that matter). As the case is with l-tryptophan, combining St. John's Worth with Cymbalta would provide a double boost of serotonin, which might theoretically cause serotonin to reach dangerously high levels in some individuals.
This risk of serotonin syndrome would obviously increase with higher doses of either Cymbalta or l-tryptophan/St. John's Wort, so it may be possible to safely combine Cymbalta with either of these supplements if the doses are low enough. But because of the risk, it would be advisable to proceed with such a combination only with great caution and under a doctor's supervision if at all.
I hope this helps.
Tomatheus
poster:Tomatheus
thread:702929
URL: http://www.dr-bob.org/babble/alter/20061118/msgs/709229.html