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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 felipe on October 17, 2002, at 0:51:55
i already bought a bottle of sjw but still have not taken it.i thought it was safer when i bought it,didnt know it had some maoi and ssri properties.im a bit afraid of taking it as i am with all medications that affect the brain.i have all kinds of antidepressants in my drawer but never took anyone.my depression is not mild and ive heard that serious depressions should not be treated with sjw.also i often drink alcohol,mostly beer and wonder if alcohol could interact with sjw, although ive heard they do not.ive also read that sjw does not interact with foods although it has some maoi properties but i want to be sure of that.also supposing it doesnt work for me how long would i have to wait to take a regular antidepressant?ive heard mixed opinions about this ranging from 2 weeks to 2 months.i even heard one person had serotonin syndrome for talking 1 1/2 dose of zoloft after6 weeks of stopping sjw.im really concerned about this because if it doesnt work my second option would be remeron which i was prescribed originally and also have it in my drawer but am afraid to take.what is the problem with anesthesia and sjw? what if i have to go to the dentist or something?
responses and advice will be greatly appreciated.
by the way what is sam-e?just another thing.when i asked my psychiatrist about sjw he didnt even know what it was.he said he didnt believe in those kind of herbal remedies and that i should stick to conventional well studied antidepressants like remeron which he prescribed me.im quite sure that most doctors around here dont know nothing about sjw and needless to say the dentist wont know either.so is there a problem with anesthesia and sjw?what should i do if i have to go to the dentist or have a cut and need stitches?is there a problem with that?the fact is i feel kind of stupid trying to explain what sjw is to doctors.what should i do in these cases or is there no problem at all?
Posted by atxbelle2000 on October 17, 2002, at 1:24:35
In reply to st john's wort question, posted by felipe on October 17, 2002, at 0:51:55
Well, it sounds like you may want to start looking for other options. Sometimes herbal remedies can be the best for you because there aren't that many side effects of taking them. Just make sure to do research on them before you start taking them. I know that taking sjw you have to be careful of sunburns because you can burn easier. Hope this helps!
Posted by Kari on October 17, 2002, at 15:25:35
In reply to st john's wort question, posted by felipe on October 17, 2002, at 0:51:55
Hi Felipe,
To be on the safe side, assume SJW is an MAOI.
I took it years ago for about a month and experienced the exact same side effects as I did on Nardil.Kari.
Posted by felipe on October 17, 2002, at 16:02:22
In reply to Re: st john's wort question, posted by Kari on October 17, 2002, at 15:25:35
kari what kind of side effects do you mean? did you have problems with food interaction?ive read tha the maoi effect in sjw is so weak that you can eat whatever you want.
Posted by ZeeZee on October 17, 2002, at 16:43:19
In reply to st john's wort question, posted by felipe on October 17, 2002, at 0:51:55
Felipe,
I was on Nardil and then Parnate for a period of almost 5 yrs for my panic disorder. I discontinued the use of Parnate and used SJW for the next 4 yrs. I have recently re-started it's use again as well. No you do not have to watch your diet. That was misinformation about the drug initially. I am super sensitive and fearful of medications. I had a reaction of agitation/anxiety and insomnia just from Omega 3, so I'm VERY careful about what I put into my body.
I have never had a problem with the sun sensitivity either, although I do not sun bathe and take the healthy precautions to avoid exposure. SJW is not a MAOI and should not cause you any difficulty. The real question is whether or not it will help you with your problems. I believe it helped me maintain gains I had from the MAOI's. Had I not taken the MAOI's for the prior 5 yrs. my brain would not have been effected enough by the SJW to do me any good.
Just my opinion.
Good Luck
Posted by ZeeZee on October 17, 2002, at 16:45:57
In reply to st john's wort question, posted by felipe on October 17, 2002, at 0:51:55
Oh, and also, no there's no problem with SJW and anesthesia or drugs used in dentistry. However, I always told my physicians and dentists I was on it. If you plan on taking a MAOI you need to wash out of the SJW for 6 weeks. For other AD's I believe it's 2-4 wks.
Posted by ZeeZee on October 17, 2002, at 16:48:26
In reply to Re: st john's wort question » felipe, posted by ZeeZee on October 17, 2002, at 16:45:57
Posted by Kari on October 18, 2002, at 11:37:40
In reply to to kari, posted by felipe on October 17, 2002, at 16:02:22
On both Nardil and SJW I developed (after several weeks) chest pains, nausea, dizziness, pain in the right side of the abdomen and a terrible "sick" feeling. On both, ironically, my social phobia symptoms improved at first and gradually worsened with time. On SJW I made no dietary changes as I didn't know it might be an MAOI.
SJW is considered by some to act as an SSRI and by others as an MAOI. I heard the effect may have something to do with the dosage as well.
Assuming that it may have such side effects and that some people may be more sensitive to it than others, perhaps it is better to refrain from foods known to interact with MAOIs.
Just my opinion...
Posted by ZeeZee on October 18, 2002, at 17:11:08
In reply to sorry..., posted by Kari on October 18, 2002, at 15:51:24
Felipe,
For those of us interested in receiving a MAOI it is a rare bird of a psychiatrist who will agree to prescribe and monitor this medication. Ask those of us on this board who have used or are using a MAOI. Considering how hestitant the Psych. community is in using this drug do you believe they would allow a similarly acting drug on the market to be purchased over the counter? I have done a lot of research on the drug and it would probably allay your fears to do the same. Just as we recommend you refer to research on MAOI's after 1996, it is recommended you read the research on SJW that has been more recent. The current research repeatedly states that intially it was believed to have a MAOI action effect. However, this has since been disputed and clarified. Whatever MAOI action it has is extreamly mild. The drugs that interact with SJW are: those used for the treatment of AID's, chemotherapy, birth control pills (reduces their effectiveness - I used both for 4 years without incident)and other antidepressants.
The biggest question to be answered is if this herb will be effective enough in treating your disorder. It is not effective for major depression, but is effective for mild to moderate depression and anxiety. It takes at least 6 weeks to take effect and you need to follow the recommendations for strength and dosage. I use 900 mgs per day with a per pill dose of .3% hypericum. I am not betting on this doing what the MAOI's did for me in the past, however in combination with psychotherapy I'm hoping it will help me to regain some ground that I have lost.
Like you, I have many prescriptions for AD's that go unfilled or end up being thrown away. The side effects for me with an anxiety disorder are immediate and for me intolerable. Anything that worsens my anxiety is intolearable. I do use Klonopin and Xanax and am still hoping that a new AD will be developed specifically to treat panic disorder.
Good Luck
Posted by ZeeZee on October 19, 2002, at 9:25:29
In reply to To Felipe, posted by ZeeZee on October 18, 2002, at 17:11:08
St. John's wort:
a new alternative for depression?
by
Josey ES, Tackett R
Department of Clinical and Administrative Sciences,
College of Pharmacy,
University of Georgia,
Athens 30602, USA.
Int J Clin Pharmacol Ther 1999 Mar; 37(3):111-9ABSTRACT
OBJECTIVE: The primary purpose of this article is to review the existing literature concerning the therapeutic uses, adverse effects, and possible drug interactions of St. John's wort (Hypericum perforatum) as compared to other antidepressant medications. METHODS: Reference material was obtained through database searches with time restrictions of 1985 to the present. Studies selected were those written in the English language which compared the role of St. John's wort, tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin-selective reuptake inhibitors in the treatment of depression. Other studies were selected based on their evaluation of the safety and efficacy of St. John's wort as an antidepressant for a minimum of four weeks. RESULTS: A review of existing literature recognized nine clinical trials that reported the efficacy of St. John's wort as compared to placebo and to other antidepressant medications. Of these nine, four controlled studies were chosen based upon their large patient populations and their consistency in brand and dosage of St. John's wort used. These four studies demonstrated that St. John's wort was as effective as other antidepressant medications and more effective than placebo, as the clinical symptoms of depression greatly decreased upon administration of H. perforatum. The side-effect profile of H. perforatum at this time appears to be superior to any current U.S.-approved antidepressant medication. CONCLUSIONS: From the existing literature, St. John's wort appears to be a safe and effective alternative in the treatment of depression. Tricyclic antidepressants and monoamine oxidase inhibitors can produce serious cardiac side-effects, such as tachycardia and postural hypotension, and many unwanted anticholinergic side-effects, including dry mouth and constipation. St. John's wort has proven to be free of any cardiac, as well as anticholinergic, side-effects normally seen with antidepressant medications. Based upon limited studies, St. John's wort appears to be an acceptable alternative to traditional antidepressant therapy, although trials on a larger scale are warranted in this area. Hypericum is available to the lay public as an over-the-counter preparation and may be misused if not fully understood.SAMe
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St John's wort: why?
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St John's wort: meta-analysis
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St John's wort: a smart antidepressant?Refs
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