Psycho-Babble Medication Thread 14151

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

prozac,xanax and St.John'Wort

Posted by ShyDi on October 29, 1999, at 9:06:52

Taking St. John's for a year (300 Mg) per day. Still
depressed, so.... started 20 mg of prozac. After
a month, depression somewhat alleviated; however, insominia
was ruining my life (missing work, trouble driving, etc.)
So.. doctor put me on Lorzapam to sleep. It didn't
work AND made me feel horrible and anxiouis...... So..
about a week ago started .5 mg of xanax at night.
Sleeping great.. Just scared of all
the drugs and this 'dopey' feeling. Looking for any
info.

 

Re: prozac,xanax and St.John'Wort

Posted by JohnL on October 29, 1999, at 14:05:02

In reply to prozac,xanax and St.John'Wort, posted by ShyDi on October 29, 1999, at 9:06:52

Hi ShyDi. Hey, I have been taking 1200mg St Johns with my Prozac for months. It's subtle. Like a vitamin, I notice when I stop using it. Might not think it works, but when I withdraw it I can tell in a negative way. I quickly go back on it cause the Prozac just doesn't work as good without it.

I have troublesome sleep with or without an AD. My favorite is 7.5mg Remeron. Knocks me out. Slight hangover in a.m. that disappears with coffee. No cloudiness during the day. Took a couple weeks to get the tolerance, but 7.5mg is very low. And it will knock you out, potentiate the Prozac+StJohns, help sex a bit, and not drug you out in the day. Trazodone is a good choice too, but I personally prefer the Remeron. You wouldn't need the Xanax, which is the one probably causing the fogginess.

 

Re: prozac,xanax and St.John'Wort

Posted by Bob on October 29, 1999, at 14:18:56

In reply to Re: prozac,xanax and St.John'Wort, posted by JohnL on October 29, 1999, at 14:05:02

Hi ShyDi

Are you seeing a general practitioner (gp) or a psychiatrist/psychopharmacologist (pdoc) for your meds?

Bob

 

response to Bob and John L.

Posted by SHyDi on October 29, 1999, at 14:41:20

In reply to Re: prozac,xanax and St.John'Wort, posted by JohnL on October 29, 1999, at 14:05:02

>JohnL. Thanks a lot for the info and may try
to ditch the xanax and try the re....

Bob. My GP is prescribing over the telephone.
See a psychologist who can't prescribe. He
recommended the Prozac. I decided on the
xanax myself based on a friends advice.

 

Re: prozac,xanax and St.John'Wort

Posted by saint james on October 29, 1999, at 15:34:39

In reply to prozac,xanax and St.John'Wort, posted by ShyDi on October 29, 1999, at 9:06:52

> Taking St. John's for a year (300 Mg) per day. Still
> depressed, so.... started 20 mg of prozac. After
> a month, depression somewhat alleviated; however, insominia
> was ruining my life (missing work, trouble driving, etc.)
> So.. doctor put me on Lorzapam to sleep. It didn't
> work AND made me feel horrible and anxiouis...... So..
> about a week ago started .5 mg of xanax at night.
> Sleeping great.. Just scared of all
> the drugs and this 'dopey' feeling. Looking for any
> info.

james here....

Since SJW is assumed to be a weak MAOI it would seem using it with any other AD a no no.

JohnL, you seem to be a well read fellow, do you have any comments on this issue ? I would be intrested in what youi have to say.

j

 

Re: prozac,xanax and St.John'Wort

Posted by JohnL on October 29, 1999, at 16:11:35

In reply to Re: prozac,xanax and St.John'Wort, posted by saint james on October 29, 1999, at 15:34:39


>
> james here....
>
> Since SJW is assumed to be a weak MAOI it would seem using it with any other AD a no no.
>
> JohnL, you seem to be a well read fellow, do you have any comments on this issue ? I would be intrested in what youi have to say.
>

Hi St James. I see a lot of controversial stuff on St Johns. Some studies show it has MAOI activity. Others show that its MAOI is so small it's unachievable or clinically irrelevant in any amount we could possibly humanly dose. So who knows. One study showed its NE uptake inhibition was four times as strong as its serotonin inhibition. Dopamine uptake inhibition too.

The saying I once heard that I agree with is that it takes many small streams to make a mighty river. Something like that. I think St Johns has multiple actions, none significant by themselves, that add up synergistically for a total result. Stuff like minimal MAOI, reuptake of all the neurotransmitters, something to do with GABA, something about inhibiting cortisone levels, and other stuff I absolutely don't understand. Not sure anyone really does.

All I can say for sure is that I have indeed been taking it with Prozac for months with some benefit and no side effects and no adverse reactions of any kind. I think I would need to double or triple my Prozac dose if I stopped the St Johns. Then I would have all kinds of side effects I don't want.

 

Re: prozac,xanax and St.John'Wort

Posted by saint james on October 29, 1999, at 17:37:11

In reply to Re: prozac,xanax and St.John'Wort, posted by JohnL on October 29, 1999, at 16:11:35

>
> >
> > james here....
> >
> > Since SJW is assumed to be a weak MAOI it would seem using it with any other AD a no no.
> >
> > JohnL, you seem to be a well read fellow, do you have any comments on this issue ? I would be intrested in what youi have to say.
> >
>
> Hi St James. I see a lot of controversial stuff on St Johns. Some studies show it has MAOI activity. Others show that its MAOI is so small it's unachievable or clinically irrelevant in any amount we could possibly humanly dose. So who knows. One study showed its NE uptake inhibition was four times as strong as its serotonin inhibition. Dopamine uptake inhibition too.
>
> The saying I once heard that I agree with is that it takes many small streams to make a mighty river. Something like that. I think St Johns has multiple actions, none significant by themselves, that add up synergistically for a total result. Stuff like minimal MAOI, reuptake of all the neurotransmitters, something to do with GABA, something about inhibiting cortisone levels, and other stuff I absolutely don't understand. Not sure anyone really does.
>
> All I can say for sure is that I have indeed been taking it with Prozac for months with some benefit and no side effects and no adverse reactions of any kind. I think I would need to double or triple my Prozac dose if I stopped the St Johns. Then I would have all kinds of side effects I don't want.

James here....

Take a look at
http://www.la-tierra.com/stjames/411onherbs.htm

an intresting paper I found, a meta study from the medical point of view of 10 herbs. Most of it bears out what you have said here...you might find the referances useful.

here in the states there is no standard for herbs like there is in Europe, studies have shown that capsule for capsule the amount of active product varies wildly. I always use tinchures because this is a concentrated product, so you get the same active product every time. I think the next big step for herbs is a national standard so one knows each dose unit contains the same amount of actives. In nature the amount of actives is well known to vary plant to plant.

i have seen a few reports of "cheese reaction" to SJW. This makes some sence as the dose of a capsule could be very high, thus making a weak MAOI strong enough to cause this reaction.

I tend to buy herbals that are made in Germany or
using the German Standard. I don't like wildcrafting, we are risking wipeing out some herbs, as goldenseal is endangered. I use herbs grown on farms where multiple strains are grown of the same herb; this get the benifits of wildcraft w/o picking the woods clean.

j


 

Re: prozac,xanax and St.John'Wort

Posted by JohnL on October 29, 1999, at 19:28:43

In reply to Re: prozac,xanax and St.John'Wort, posted by saint james on October 29, 1999, at 17:37:11

St James, dittos on European herbs. I think they're the only ones we can trust for consistency. And in any effort to duplicate a clinical study those are the ones actually used. Kira is the USA brand of LI160, the formula used in those studies, and manufactured by the very company. I requested email info from them a month ago. Their response was in line with what we've already discussed. That St Johns has many active components. Many of them still unknown. They confirmed that hyperforin is a major player, but that it alone is questionable without all the other components of LI160 working in synergy.

After reading your last post it reminded me of something I forgot. That most of the MAOI in St Johns is in the raw herb. Thus the possible cheese reaction when using any of the brands other than LI160. Especially the ones that have raw herb mixed in with the extract. I'm very sensitive to tinnitus. Kira doesn't give me much problem. I did try a brand once that had raw herb mixed in, and it made my tinnitus real bad. So there might be something to that.

Thanks much by the way for the website tip.

 

Re: prozac,xanax and St.John'Wort

Posted by saint james on October 29, 1999, at 23:07:44

In reply to Re: prozac,xanax and St.John'Wort, posted by JohnL on October 29, 1999, at 19:28:43

Kira is the USA brand of LI160, the formula used in those studies, and manufactured by the very company. I requested email info from them a month ago. Their response was in line with what we've already discussed. That St Johns has many active components. Many of them still unknown. They confirmed that hyperforin is a major player, but that it alone is questionable without all the other components of LI160 working in synergy.
>
> After reading your last post it reminded me of something I forgot. That most of the MAOI in St Johns is in the raw herb. Thus the possible cheese reaction when using any of the brands other than LI160. Especially the ones that have raw herb mixed in with the extract.

James here...

My thoughts exactually. German doc's have been perscribing standardized hyperforin for a long time with no reported problems at all (cheeze reaction) The few (2) reports I saw about a cheeze recction were in the states, probably whole herb product. There is a huge amount of research, most of which has not been translated
from German.

The whole issue of synergy is well documented in biology. Mother nature doesn't produce one agent,
many things work in harmony. A good example of this is Marinol (delta-9 THC). Delta-9 THC is the major, most studied, active canibinoid in pot, but there are ~25 other canibinoids. I friend w/ AIDS tried it and found all it did was knock him on his ass. Could not get out of bed and did not have much of the anti-nausea effects (the reason he was taking it) Smoking the whole herb was clearly very different and produced the desired effect (able to leave the bathroom, house and be involved in life)

j

 

Re: prozac,xanax and St.John'Wort

Posted by JohnL on October 30, 1999, at 3:40:35

In reply to Re: prozac,xanax and St.John'Wort, posted by saint james on October 29, 1999, at 23:07:44

Just wanted to clarify one point. Because Prozac+St Johns is a benign mix for me personally, adding St Johns to any AD has the potential for very disturbing adverse reactions. There was a documented case of Paxil+St Johns being extraordinarily sedating. That happened with me too. I couldn't drive more than 5 minutes without having to pull off the road and nod out. It was a nightmare. Thought I would never come back from the ozone. That trial lasted a day. See ya!

Then with Zoloft the St Johns gave me a continuous panic feeling. Like butterflies in the stomach. That terror one might get before getting up in front of a crowd or something. I tried once and then again a month later just to see. It was bad. No way Jose.

I do recall someone here months ago uses St Johns with Zoloft. So these strange reactions don't happen with everyone. But with all the unknown mechanisms of St Johns, who knows how it reacts on a molecular level when combined with any of the SSRIs. For me it's fine with Prozac, but a nightmare with anything else.

Just wanted to say if anyone else experiments with adding St Johns to an AD, it is wise to start with just one pill a day and feel it out before continuing. Also let the doc know. My own doc was the one who first suggested it. Brave soul he is. Must have good malpractice insurance. This is like venturing in uncharted waters. Might be a pleasant sail, might be a shipwreck. If one is to try it, approach with a sense of caution and see how it goes.

 

Re: SSRI's, St.John'Wort & SAMe -- JohnL

Posted by dj on October 30, 1999, at 12:34:18

In reply to Re: prozac,xanax and St.John'Wort, posted by JohnL on October 30, 1999, at 3:40:35

I imagine that part of the problem is that there are so many variations in the quality of SJW in the marketplace that, that also is another kink in this unpredictable mix.

JohnL I believe you use or also used SAMe in your chemical cocktail. How does or did this effect this mix?

> But with all the unknown mechanisms of St Johns, who knows how it reacts on a molecular level when combined with any of the SSRIs.

 

Re: SSRI's, St.John'Wort & SAMe -- dj

Posted by JohnL on October 30, 1999, at 13:36:59

In reply to Re: SSRI's, St.John'Wort & SAMe -- JohnL, posted by dj on October 30, 1999, at 12:34:18


> JohnL I believe you use or also used SAMe in your chemical cocktail. How does or did this effect this mix?

Hi dj. I actually don't use SAMe much. About every 2 weeks or so I get the inclination to try some yet once again. At a dose of 600mg to 1200mg I run out after 5 days. During that 5 days I do notice a subtle potentiation of the whole cocktail. Kind of like an incoming tide lifting a boat. The effect seems to last about 2 weeks after discontinuation. I also notice a profound improvement in sexual desire when taking it. That also lingers for a couple weeks after. I wonder if that may be a reason Prozac isn't giving me trouble. I wonder if that might be something to try for someone with sexual dysfunction. Not sure. I find it also numbs my chronic low-grade hip/lower back pain nicely. It is supposed to be good for joint mobility, and I think it really is.

I really don't like too many ingredients in a cocktail though. I don't like SAMe's high price either. So I only use it once in a while. Considering my anhedonia is still as bad as ever, even though other depressive symptoms are gone, I'm not yet satisfied with the current cocktail anyway. Sometimes I just want to ditch everything and start over from a different angle. I probably will sooner or later. Just can't take anhedonia forever. I hesitate though because Prozac is about the only thing so far that quiets my tinnitus while so many other things worsened it. But I'm getting off subject here. Maybe the perspective on SAMe might be of interest to someone.

 

Re: prozac,xanax and St.John'Wort...back to ShyDi

Posted by Bob on October 30, 1999, at 17:14:09

In reply to prozac,xanax and St.John'Wort, posted by ShyDi on October 29, 1999, at 9:06:52

So, you're on SJW, prozac, and xanax.

I'm sure there are lots of folks out there that get a lot out of xanax, but the other stories I've heard would make me shy away from it.

As you can see, we've quite the group of herbal experts in this crowd, so let me throw out a suggestion for them to comment upon, based upon an archived thread:

If its insomnia that is bothering ShyDi, how about sublingual melatonin for that? As an alternative, how about sublingual valerian? What, too, about her SJW and Prozac dosages? Could one be too high or otherwise out of whack?

ShyDi, a lot of us around here kind of automatically say "get thee to a pdoc" if its a gp doing the prescribing, simply because most gps don't have the training, no matter how well-meaning they are, to handle the subtleties of psychopharmacology. But if you really don't want to get too weighted down in meds and don't mind the herbs, then getting some advice from the expert practitioners here may be just fine. Also, if you can't afford the additinal expense and you're feeling stable enough, do what you gotta do.

But keep an eye on yourself, and don't be a stranger here. If you start to backslide, let us know and THEN we'll all *hound* you to get to a pdoc or ER or whatever seems to be called for! ;^)

be well
Bob

 

Re: prozac,xanax and St.John'Wort...Melatonin?

Posted by SHYDI on November 1, 1999, at 7:44:32

In reply to Re: prozac,xanax and St.John'Wort...back to ShyDi, posted by Bob on October 30, 1999, at 17:14:09

>Thanks everyone for all the good info. This weekend I cut the xanax
dosage in half and still slept. I may take Bob's
advice and try melatonin and skip the xanax before
I'm addicted (I've been on it a week). I bought the 1 MG pills
but not sure how much is appropriate. Any suggestions.
This depression is a strange thing. I've always been
able to beat it with relaxation tapes, good books, positive
self-talk, etc. but this time it's tough. I even went to the
GYN and checked to see if maybe I was an early menopause person but
I'm AOK there. Everything in my life is bad right now but I've
always been a positive person so this is wierd. I did
quit a 25 year smoking habit a few months ago with
wellbutrin and the patch. So. I'm thinking that so many
years of smoking shut down my serotonin production. Oh well,
sorry for rambling just looking for suggestions on the
melatonin dosage. It's really great to have a place
to turn to because friends just don't understand depression.
They kind of act like "get over it!".

 

Re: Melatonin?

Posted by Bob on November 1, 1999, at 11:10:35

In reply to Re: prozac,xanax and St.John'Wort...Melatonin?, posted by SHYDI on November 1, 1999, at 7:44:32

> It's really great to have a place
> to turn to because friends just don't understand depression.
> They kind of act like "get over it!".

Some friends, eh? ;^)

Here's a copy of something Dove posted to a thread in the Oct1 Archive on melatonin (hope you don't mind me copying this, dove):

Here is the low-down on the best in results and with no side-effects. Sublingual Melatonin, the kind that you let melt under your tongue. I only need half of 1 mg. ( 0.5 mgs) My daughter needs only 1/4 of a 1mg. sublingual pill. The response is incredible, fast (I mean rapid) it doesn't leave you feeling droggy in the a.m., although it doesn't change the way a person normally acts in the morning (like me being scatter-brained and crabby) and it does NOT cause depression in either one of us. I truly believe it does the opposite, getting enough sleep is a God-send.

---
So, I hope you got the sublingual kind and I hope Dove's experiences mirror your own. I know when I took the regular tablets, the sleep was great but the hangover was awful.


Good luck,
Bob


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