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Dr. Bob is Robert Hsiung, MD,
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Posted by morgan miller on August 29, 2010, at 12:46:18
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 29, 2010, at 12:38:29
That's a health food store assistant. My psychiatrist had no problem with me taking a little SJW with Prozac, and I had no negative reactions. Do some real research and you will find that it is ok to combine antidepressants in many instances.
Posted by sewerrat on August 29, 2010, at 14:42:47
In reply to Re: St Johns Wort Combined with SSRI's » sewerrat, posted by morgan miller on August 29, 2010, at 12:46:18
Less is more,?? you are talking about your shrink. Does he also put diesel in his petrol car.
Posted by morgan miller on August 29, 2010, at 15:40:09
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 29, 2010, at 14:42:47
> Less is more,?? you are talking about your shrink. Does he also put diesel in his petrol car.
Bad comparison. Did you get the part where I said that it might be necessary to lower the dose of one antidepressant if another was added?
Less is always ideal, but not always more or better. That would have been like me saying that 100 mg of Zoloft was simply too much and I would have felt better on 25 or 50 mg. The fact was that 100 mg was my sweet spot where I felt the best and experienced no negative side effects.
Like I said, do some hard research, and put a little more thought and consideration into this before you jump to such simple generalized conclusions about treating depression. What is believed in convention is not always the truth.
My psychiatrist did not tell me to take SJW with Prozac, I told him I was going to try it. He decided to lower the dose of Prozac and told me to watch out for any signs of serotonin syndrome. He was not too concerned though. When I was transitioning from Zoloft to Symbyax, he kept me on 100 mg of Zoloft for the first 3 weeks on Symbyax. I was on both Zoloft and Symbyax for just over a month without any problems.
The reality is, serotonin syndrome can happen to anyone that is on an antidepressant alone. Who really knows why some are more prone to it than others. If you are careful about what you do, and pay close attention to how you react, you will be able to keep yourself safe.
If you have read one of the lasts posts here, you would have seen that Scott was experiencing sighs of serotonin syndrome when he replaced Parnate with Nardil, in a regimen that included both Lithium and Nortriptyline. He figured out that Lithium may have been the variable that was pushing his brain into this state. He removed the Lithium and was fine. He is still taking Nardil, Nortriptyline, Lamictal, and Abilify. Oh and btw, if you didn't know, Lamictal probably boosts serotonin through some mechanism as well. That makes 3 medications in his regimen that boost serotonin. Are you going to tell him that he shouldn't be doing this?
Posted by sewerrat on August 30, 2010, at 4:26:22
In reply to Re: St Johns Wort Combined with SSRI's, posted by morgan miller on August 29, 2010, at 15:40:09
Yes ,from what i have read of scotts posts, he takes far to many different meds. His choise of course ,just my opinion.He never seems to get much remission on these cocktails only more side effects. SJW is a MAOI so i hope you have started you new diet to fit in with your abscure choise of meds.Of course i have read every interation with sjw an ad,s , plus it tells you on every leaflet you get with your meds. Your shrink has put you on it your happy.Have a read through other med forum,s an you are a trail blazzer, ie the only one i can find in your serotonine syndrom high rate choise
Posted by SLS on August 30, 2010, at 5:51:33
In reply to Re: St Johns Wort Combined with SSRI's » morgan miller, posted by sewerrat on August 30, 2010, at 4:26:22
> Yes ,from what i have read of scotts posts, he takes far to many different meds.
According to whose paradigm?
> His choise of course ,just my opinion.He never seems to get much remission on these cocktails only more side effects.
Yup. I guess I should stop looking, right? Where is the logic in that?
> SJW is a MAOI so i hope you have started you new diet to fit in with your abscure choise of meds.
I know that there was great debate about this 10 years ago. Can you produce a recent citation that offers evidence of pharmacologically significant MAO inhibition by SJW?
Thanks.
"Early in vitro studies of various components of St. John's Wort extract led to the establishment of MAO inhibition as the possible mechanism for Hypericum's antidepressant effects. [ 10,11 ] However, more recent investigation in this area suggests that, although MAO inhibition does occur with high concentrations of Hypericum constituents, it does not in the amounts found in commercial extracts."
http://www.chiro.org/nutrition/ABSTRACTS/St_Johns_Wort_Clinical_Effects.shtml
Unfortunately, this is not a citation of the original work. It is a paraphrase. I am still trying to find abstracts on Medline that support MAO inhibition as a property of SJW. All I can find are abstracts that refute this notion.
http://www.ncbi.nlm.nih.gov/pubmed/15536462
- Scott
Posted by ed_uk2010 on August 30, 2010, at 7:21:25
In reply to Re: St Johns Wort Combined with SSRI's » sewerrat, posted by SLS on August 30, 2010, at 5:51:33
Well, I knew about the alleged interaction, but I decided to add SJW anyway (to a high dose of an SSRI). Unfortunately, it didn't help. No side effects though, except maybe slight drowsiness. I tried if for about one month. Maybe I should have given it a bit longer.
Posted by sewerrat on August 30, 2010, at 13:06:17
In reply to Re: St Johns Wort Combined with SSRI's, posted by morgan miller on August 29, 2010, at 15:40:09
Posted by SLS on August 30, 2010, at 15:04:35
In reply to There are hundreds of articles like this, posted by sewerrat on August 30, 2010, at 13:06:17
I would like to see a citation offering investigative evidence rather than a paraphrase without references that SJW acts as an antidepressant through MAO inhibition.
- Scott
Posted by ed_uk2010 on August 30, 2010, at 15:44:01
In reply to Re: There are hundreds of articles like this, posted by SLS on August 30, 2010, at 15:04:35
>I would like to see a citation offering investigative evidence rather than a paraphrase without references that SJW acts as an antidepressant through MAO inhibition.
It seems to me that in psychiatry (and perhaps medicine in general), ideas become 'established' through repetition and quoting of others, not due to investigative evidence.
Posted by SLS on August 30, 2010, at 16:06:53
In reply to Re: There are hundreds of articles like this » SLS, posted by ed_uk2010 on August 30, 2010, at 15:44:01
> >I would like to see a citation offering investigative evidence rather than a paraphrase without references that SJW acts as an antidepressant through MAO inhibition.
> It seems to me that in psychiatry (and perhaps medicine in general), ideas become 'established' through repetition and quoting of others, not due to investigative evidence.
Exactly.
- Scott
Posted by morgan miller on August 30, 2010, at 17:04:58
In reply to Re: St Johns Wort Combined with SSRI's » morgan miller, posted by sewerrat on August 30, 2010, at 4:26:22
> Yes ,from what i have read of scotts posts, he takes far to many different meds. His choise of course ,just my opinion.He never seems to get much remission on these cocktails only more side effects. SJW is a MAOI so i hope you have started you new diet to fit in with your abscure choise of meds.Of course i have read every interation with sjw an ad,s , plus it tells you on every leaflet you get with your meds. Your shrink has put you on it your happy.Have a read through other med forum,s an you are a trail blazzer, ie the only one i can find in your serotonine syndrom high rate choise
Please, please do more research before making statements about having to get on a tryptamine free diet because SJW is an MAOI. If SJW has any MAOI action, it is very very week. Millions of people are taking SJW and NEVER have to watch their diet due to concerns over adverse reactions.
Morgan
Posted by morgan miller on August 30, 2010, at 17:08:12
In reply to There are hundreds of articles like this, posted by sewerrat on August 30, 2010, at 13:06:17
Please give us a real legitimate source like a recent pubmed study. I couldn't even access that article you linked. Also, make sure you don't link an article with someone's opinion.
Posted by Phillipa on August 30, 2010, at 21:12:27
In reply to Re: There are hundreds of articles like this, posted by morgan miller on August 30, 2010, at 17:08:12
Just my thought buy if ST Johns Wort sold over the counter was really an maoi would that be legal? As the side effects would be dangerous to those that just see take st johns wort for depression. All I know is it states for mild to moderate depression. My nephew says it takes it and it eliminates anxiety which runs in my family. Any truth in that as couldn't turn up much in googling. Thanks Phillipa
Posted by morgan miller on August 30, 2010, at 21:36:43
In reply to Re: There are hundreds of articles like this, posted by Phillipa on August 30, 2010, at 21:12:27
Good point Phillipa
Posted by sewerrat on August 31, 2010, at 4:17:54
In reply to St Johns Wort Combined with SSRI's, posted by Phillipa on August 27, 2010, at 13:41:30
Your phychiatrist is someone else,s oppinion.Another doc would have the opposite oppinon .So you are baseing you posts on someones opinion. ie yours. You asked the doc to try sjw. i just put one of thounsands of reports on it in a link , it wasnt a forum answer.I am in fact trying to look after your interest by not adding another toxic herb into your body with other meds,on its own fine. I see no prob,s.your phychiatrist didnt recommend sjw ,he only aggreed to you useing it.Your in america, her in england sjw is insilled in are brain not to mix, you do what you like in america you already use cocktails that scare ud brits to death. Every new med added add,s a new side effect. in the end thats what you are a massive side effect . you have that many chemical,s in your bodies you will soon have to be buried in a toxic dump.Less is more you take meds for problem,s more meds for the side effects from the first med , meds for the side effects to your second med.In the end your on 8 meds for one illness but create in therory more.As for google someone mentioned look hard enough an you will find 20 answer,s to the same question rendering the site usless
Posted by SLS on August 31, 2010, at 5:46:33
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 31, 2010, at 4:17:54
If anything, there might be a contraindication between taking SJW and a MAOI together. There have been reports of SJW having 5-HT reuptake inhibitor properties. I haven't kept up with the latest research. SJW has been known to produce serotonin syndrome when combined with other antidepressants.
http://www.ncbi.nlm.nih.gov/pubmed/11603291
http://www.ncbi.nlm.nih.gov/pubmed/14692732
- Scott
Posted by morgan miller on August 31, 2010, at 9:25:57
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 31, 2010, at 4:17:54
I understand what you are saying. Still, the claims that SJW is a potent MAOI that requires dietary restriction are inaccurate. And, as far as sites like Pubmed go, the reason why people go there for information is because it is reliable and unbiased. There are places on the internet where you can find reliable information, you just have do some research and figure out which ones are reliable and which are not.
>i just put one of thounsands of reports on it in a link
Where are these thousands of reports?
Posted by sewerrat on August 31, 2010, at 13:21:32
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 31, 2010, at 4:17:54
Scotts second link is all i have tried to tell you.You do as you like, i was just trying to warn you of possible risk,s thats all.I still say its a MAOI, all but a weak one.Its just that i have found over the year,s a lot of the so called add on herb,s have more side effects than your meds
Posted by Phillipa on August 31, 2010, at 20:05:12
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 31, 2010, at 13:21:32
Hi M
Posted by Huxley on September 1, 2010, at 1:35:08
In reply to Re: St Johns Wort Combined with SSRI's, posted by sewerrat on August 31, 2010, at 4:17:54
> Every new med added add,s a new side effect. in the end thats what you are a massive side effect . you have that many chemical,s in your bodies you will soon have to be buried in a toxic dump.Less is more you take meds for problem,s more meds for the side effects from the first med , meds for the side effects to your second med.In the end your on 8 meds for one illness but create in therory more.
The most sensible post I have read on this site. It astounds me that such obviously intelligent people can't see this and continue to ply themselves with more and more chemicals.
Posted by ed_uk2010 on September 1, 2010, at 6:45:48
In reply to Re: St Johns Wort Combined with SSRI's, posted by Huxley on September 1, 2010, at 1:35:08
>It astounds me that such obviously intelligent people can't see this and continue to ply themselves with more and more chemicals.
Combinations can work well, but they can also do a lot of damage. I've settled on one medication right now, but some people might do better on two or three.
For a combination to work out, each medication should be producing a clear benefit and minimal adverse effects. Whenever a new medication is added, consideration should be given to stopping something else. Drug interactions also need to be taken into consideration.
Posted by morgan miller on September 1, 2010, at 21:22:53
In reply to Re: St Johns Wort Combined with SSRI's, posted by Huxley on September 1, 2010, at 1:35:08
The reason for using a few different medications is the different mechanisms of action. Unfortunately, things can get complicated up there in that still very mysterious brain of ours, and there are not highly effective medications that are customized for the complex needs of each individual. Psychiatry is still in a very archaic state.
I do think some are taking way too many medications and this in the end can make things worse rather than better.
Posted by Huxley on September 2, 2010, at 5:13:59
In reply to Re: St Johns Wort Combined with SSRI's, posted by morgan miller on September 1, 2010, at 21:22:53
> The reason for using a few different medications is the different mechanisms of action. Unfortunately, things can get complicated up there in that still very mysterious brain of ours, and there are not highly effective medications that are customized for the complex needs of each individual. Psychiatry is still in a very archaic state.
>
> I do think some are taking way too many medications and this in the end can make things worse rather than better.4 months ago I was an agitated, jittery, heavily depressed mess of a person with regular suicidal thoughts. My doctor was trying to tell be I had rapid cycling bipolar disorder.
I have slowly cut most of my med doses in half (Zyprexa Pristiq and Lactimal).
I have improved out of site. My mind is clearer, I am no longer horribly agitated. My general anxiety is pretty much gone or back to a 'normal' level. My mood is generally low to average but that is a pretty big step up from suicidal.
I still have my original social anxiety, what I initially started taking medication for.Changes in your being are so subtle that you don't realise what effects these drugs are having on you until you escape the effects and look back. When you are on three or four it is so hard to tell what is causing what.
You are most likely being treated for the side effects of one drug with another and so an and so on until you end up in a bit of a mess.
Case in point. I was in a drug induced state of depression agitation and anxiety.
Posted by morgan miller on September 2, 2010, at 11:06:46
In reply to Re: St Johns Wort Combined with SSRI's ) Morgan, posted by Huxley on September 2, 2010, at 5:13:59
Hey Huxley,
So you are still taking those 3 medications but you just cut down the doses significantly, right?I know when I took Lamictal I could not handle more than 100 mg and I did not want to go to 150 or 200 to see if the side effects were transient or dose related. I realize it is possible that I may have felt even better at 200 mg, and maybe I should have kept going up, but after feeling as bad as I did on 125 I just could bring myself to keep raising the dose.
When I was on Zyprexa, it was just too easy for me to sleep in and ruminate over negative things. It's as if Zyprexa helped me with the acute mania but the put me in a state of excessive sleep and locked the negative thoughts in my head with no way to escape. Zyprexa was not the only cause of my rumination/obsession, but it sure appears to make things worse in this respect. I also really don't like the fact that I could just sleep for 10 to 12 hours if I wanted to sometimes, waking up several times but miserably putting myself back into the world of worthless emptiness. So I eventually dropped Zyprexa and upped my dose of lithium. Lithium is not without it's downside. I'm going to give it a few months at 600 mg and see if my brain and body adjust to the point that I do not feel like I am taking anything or feel medicated at all. I used to feel like this on Zoloft monotherapy. It's what all of us are reaching for.
I'm all about a minimalist approach. I have been able to get down to just 2 medications, Prozac and Lithium. I admit though, I may have to go back to Zoloft and try adding Nortriptyline to the mix. I just need some extra help since I have so much going on physically and no longer can I do things that really made a positive impact on my mood and brain function like running, playing basketball, dancing or go to the gym and have great work outs. I also think the stress and depression combined with medication trials has put my brain in a state that requires more than it did before.
So do you believe that each medication you are taking is helping you in some way?
Morgan
Posted by Huxley on September 2, 2010, at 20:47:43
In reply to Re: St Johns Wort Combined with SSRI's ) Morgan » Huxley, posted by morgan miller on September 2, 2010, at 11:06:46
Yes I think that each med helps in some way but I also think it is hard to tell if they are helping in some way or if when I stop them It seems like they are helping because I get horrible withdrawals.
It is also hard to tell if these meds have ongoing effects.. i.e once you have taken them you have permanently damage part of your brain.
At my peak I was on
400mg Lactimal
5mg Zyprexa
50mg PristiqAm now on
50mg Lactimal
roughly 1mg of zyprexa
20 mg of pristiq.It was very hard coming down to those doses, the last 2 months have been quite hellish but I seem to have levelled out and am feeling good.
I get terrible withdrawal from zyprexa if I go any lower. I can't continue to function in life e.g jobe relationships. There is not much info out there on neuroleptic withdrawall.
The withdrawal from Pristiq is bearable if I go slowly.
The interesting thing is, I have read many ancedotal experiences of people on an SSRI for pain or other strange use and when they come off they are extremly depressed, anxious and with symptoms of bipolar for years after they stop even though they never had any symptoms to start with.
I am taking a similar approach to you. Going as low as I can possibly go.
I also have the goal of eventually getting off everyting even if it takes 5+ years.
Once you are on these drugs long term there is no quick way off.
This is the end of the thread.
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