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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Noa on February 2, 2000, at 22:56:34
With SJW, is it advisable to keep a consistent dosing frequency, or can it be taken as needed? What happens if doses are skipped?
Thanks.
Posted by jd on February 2, 2000, at 23:42:59
In reply to Looking for more info on St Johns Wort, posted by Noa on February 2, 2000, at 22:56:34
Most research shows that the active ingredients in SJW have very long half-lives, generally several days to a week or more. (It's a bit like Prozac in this respect.) This means that skipping it for a day or two probably won't make a huge difference; on the other hand, it also means that it builds up steadily in your body with repeated dosing, so that taking it regularly results in higher blood levels. When I tried it, I found I was so sensitive that I could take a half-capsule every three days without any sense of ups & downs--taking a sixth of a capsule every day was just too darn annoying. Again, a downside of all this is that it takes a LONG time to get SJW out of your system, so one probably needs to be extra careful when switching from it to other meds.
best,
jd
> With SJW, is it advisable to keep a consistent dosing frequency, or can it be taken as needed? What happens if doses are skipped?
>
> Thanks.
Posted by JohnL on February 3, 2000, at 3:39:42
In reply to Looking for more info on St Johns Wort, posted by Noa on February 2, 2000, at 22:56:34
Hi Noa,
Below are some sites loaded with info on SJW. From what I gather, consistent dosing is needed because accumulation is slow. SJW won't work on an as-needed basis. It comes on slowly, with results at 4 weeks better than 2, 6 weeks better than 4, and 12 weeks better than 6. I think it takes up to three months to reach full effectiveness. At that point I doubt missing doses would make much difference.
I saw an abstract where it was determined that a 300mg pill of SJW is roughly equivalent to 10mg of a tricyclic antidepressant. Some of the clinical studies with the best results using SJW used doses of 1800mg or 2700mg a day, which is 2 and 3 times higher than stated on the bottle. These higher doses would logically correlate with typical therapeutic doses of tricyclics. I think in general the 3 pills a day dose common in USA is way too low. Anyway, here's some reading that will keep you busy for a while:
www.primenet.com/~camilla/STJOHNS.FAQ
www.hypericum.com
Enjoy. :) JohnL
Posted by Noa on February 3, 2000, at 5:24:32
In reply to Re: Looking for more info on St Johns Wort, posted by JohnL on February 3, 2000, at 3:39:42
Thanks.
Posted by anita on February 4, 2000, at 22:41:48
In reply to Re: Looking for more info on St Johns Wort, posted by Noa on February 3, 2000, at 5:24:32
Hi Noa,
Just thought I'd add that I got a much better response from SJW when I upped my dose from 900mg to 1500mg per day. I do take it in three divided doses during the day, but I don't notice a difference if I forget a dose (have been taking it for 3 months).
anita
Posted by Peter on February 5, 2000, at 13:16:56
In reply to Re: Looking for more info on St Johns Wort, posted by anita on February 4, 2000, at 22:41:48
Anybody know about the best SJW brands to use? I'm thinking about giving it another try. Thanks. Peter
Posted by Cam W. on February 5, 2000, at 17:02:58
In reply to St Johns Wort Brands?, posted by Peter on February 5, 2000, at 13:16:56
> Anybody know about the best SJW brands to use? I'm thinking about giving it another try. Thanks. Peter
Peter - Kira and Perika are good, reliable, standardized brands. They cost more, but are probably more consistent in strength than the bargain brands. Remember, St.John's wort is for mild to moderate depression only. - Cam W.
Posted by JohnL on February 6, 2000, at 3:58:53
In reply to St Johns Wort Brands?, posted by Peter on February 5, 2000, at 13:16:56
Kira and Movana, at most drug stores, Wal*Marts, Kmarts, etc, are the same LI160 formula used in clinical trials. Pharmaceutical grade. Nature's Way Perika at some health food stores is also. There is a theory that the hyperforin content--more than the commonly assumed hypericin content--is the more important ingredient. LI160 formulas have between 3% to 5% hyperforin. With other brands you may or may not get that.
While theories suggest there are many modes of action of SJW, one possible mode is MAO inhibition. However, any MAOI action is theoretically found in the raw herb, not the extract. I have heard reports of people taking LI160 as a base treatment, and taking another brand in addition that has raw herb mixed in it to cover all the possible bases.
While the standard dose of 3 pills a day might be OK for mild to moderate depression, some clinical trials used either 6 or 9 pills a day for more severe depression. One clinical study determined that one 300mg pill of SJW is roughly equivalent to 10mg of a tricyclic antidepressant. So it makes sense that 6 to 9 pills a day is more in line with therapeutic doses.
Posted by Michael Sleeseman on April 10, 2000, at 17:12:51
In reply to Looking for more info on St Johns Wort, posted by Noa on February 2, 2000, at 22:56:34
> With SJW, is it advisable to keep a consistent dosing frequency, or can it be taken as needed? What happens if doses are skipped?
>
> Thanks.Does SJW interfere with oral contreceptive effectivity?
Posted by Cam W. on April 10, 2000, at 19:26:27
In reply to Re: Looking for more info on St Johns Wort, posted by Michael Sleeseman on April 10, 2000, at 17:12:51
> > With SJW, is it advisable to keep a consistent dosing frequency, or can it be taken as needed? What happens if doses are skipped?
> >
> > Thanks.
>
> Does SJW interfere with oral contreceptive effectivity?Michael - As with any antidepressant, SJW must be taken regularily to be effective. Missing a dose every once in a while is no big deal. Missing several doses in a row will lower your blood levels of SJW to below minimum effective concentration and will take time to build up to effective concentrations (about 5 days).
As for oral contraceptives interacting with SJW, I have not seen any literature saying that it does. This does not mean that there is not an interaction between the two drugs, just that it hasn't been documented, so I can't say for certain.
Hope this helps - Cam W.
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