![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 89. This is the beginning of the thread.
Posted by bulldog2 on November 2, 2009, at 18:55:47
This is a powerful herb and must be treated as if it is a pharmaceutical. Many herbs are as powerful as pharmaceutical Meds.Please read the following post.
DO NOT ever take St. John's Wort IT IS DANGEROUS
--------------------------------------------------------------------------------
Hi everyone
I took St. John's Wort back in November 2008 (last year) as I suffer from anxiety and it has some indication for use in anxiety. It was one of the biggest mistakes I have made in recent years. I will tell you why.
I took a UK brand called Natures Aid St. John's Wort Standardised 500mg for barely over a week. I came off it because it made me feel very drowsy, a bit stoned and it was causing my eye lids to really droop.
One thing though I never expected was for it to cause PERMANENT LONG TERMS EFFECTS AND DAMAGE. I will explain this.
In the weeks, that followed this brief spell, I experienced a terrible withdrawal - the worst I have ever had. I hadn't previously felt all that depressed - just anxious. As a withdrawal effect, I felt very depressed, and yet I had hardly taken it for any length of time.
Also, strangely I had developed droopy eyelids, visual disturbances (blurred and double vision) and facial spasms on taking it which continued on stopping. I had never previously had these problems at all.
I went to see my GP who referred me to a neurologist. The neurologist diagnosed me as having blepharospasm (a dystonia) caused sometimes as the result of taking medicines in this case St. John's Wort.
Blepharospasm and facial spams are a serious thing - this never happened when I took prozac many years ago. Now, I have double and blurred vision for brief periods sometimes hundreds of times a day - thanks to St. John's Wort. I also have facial spasm and eye muscle involuntary spasms.
I took this 'medicine' because the media falsely tells you it is safe. St. John's Wort IS NOT SAFE. It has left me with far greater problems than I had before I took it. All I can do now is try and get treatment for my blepharospasm - a difficult condition to treat successfully.
I am also determined to raise awareness of the DANGERS OF ST. JOHN's WORT. I was duped into thinking it is safe treatment. IT IS NOT SAFE. If you have depression, do try natural things like exercise, meditation etc. If that fails, see your doctor for professional advice. In my advice, BE SURE TO STAY AWAY FROM ST. JOHN's WORT.
LF123
View Public Profile
Send a private message to LF123
Find all posts by LF123#2 31st August, 2009, 01:28 PM
LF123
New Member Join Date: Aug 2009
Posts: 6
Posted by DavidSmith on November 2, 2009, at 20:19:51
In reply to You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 2, 2009, at 18:55:47
I felt suicidal after taking STJ.
Posted by Phillipa on November 2, 2009, at 20:25:53
In reply to Re: You Must Use Caution With St. Johns Wort, posted by DavidSmith on November 2, 2009, at 20:19:51
Really? It's sold over the counter???? Phillipa
Posted by linkadge on November 2, 2009, at 21:16:44
In reply to Re: You Must Use Caution With St. Johns Wort, posted by Phillipa on November 2, 2009, at 20:25:53
Do not ever take SJW??? I'm sorry. Many many people have had benefit from SJW.
SJW is not without side effects, but most studies have shown a mild side effect profile compared to other psychiatric medications. Sure, there are extreme reactions but these may be alergic. I would definately not go so far as to tell nobody to take it.
If you are taking other medications it is always prudent to talk to a doctor before starting it.
Linkadge
Posted by DavidSmith on November 2, 2009, at 21:23:19
In reply to Re: You Must Use Caution With St. Johns Wort, posted by linkadge on November 2, 2009, at 21:16:44
I agree with you about the professional consult.
My twin brother tried SJW independently
and experienced the same side effects.Truly each body is different.
Posted by metafunj on November 2, 2009, at 23:47:00
In reply to Re: You Must Use Caution With St. Johns Wort, posted by DavidSmith on November 2, 2009, at 21:23:19
One time I tried it and it made me feel artificially happy like I had a smile glued to my face and I felt warm and good inside, but there was no depth or reason to the feeling. Music still didn't do much for me so I stopped. I tried it again years later, same brand that had changed names, and I got sunburn and erectile dysfunction that didn't go away until I took and stopped Lexapro. weird.
Posted by bulldog2 on November 3, 2009, at 6:47:12
In reply to Re: You Must Use Caution With St. Johns Wort, posted by linkadge on November 2, 2009, at 21:16:44
> Do not ever take SJW??? I'm sorry. Many many people have had benefit from SJW.
>
> SJW is not without side effects, but most studies have shown a mild side effect profile compared to other psychiatric medications. Sure, there are extreme reactions but these may be alergic. I would definately not go so far as to tell nobody to take it.
>
> If you are taking other medications it is always prudent to talk to a doctor before starting it.
>
>
>
> Linkadge
>It is now connected to cataracts and it can intefere with your prescription meds. Perhaps sjw needs a warning on the bottle. Or it needs to become a pescription med so it is prescribed correctly.
Posted by TenMan on November 3, 2009, at 9:13:30
In reply to Re: You Must Use Caution With St. Johns Wort, posted by linkadge on November 2, 2009, at 21:16:44
> Do not ever take SJW??? I'm sorry. Many many people have had benefit from SJW.
>
> SJW is not without side effects, but most studies have shown a mild side effect profile compared to other psychiatric medications. Sure, there are extreme reactions but these may be alergic. I would definately not go so far as to tell nobody to take it.
>
> If you are taking other medications it is always prudent to talk to a doctor before starting it.
>
>
>
> Linkadge
>
This.That post you provided is one post on a forum of thousands. The overwhelming majority of posters there have had a good or even miraculous experience using the herb. Phrases like, "this changed my life" are quite common.
SJW has been in use for far, far longer than any pharmaceutical medication. It has been used in millions of doses by almost as many people worldwide and has a proven track record of being relatively safe and just as effective as its newer synthetic cousins.
I personally have tried several prescription antidepressants and nothing has come close to the efficacy and ease of use that SJW has provided.
Is it effective? Yes. Very much so. Is anything that is effective going to carry a risk profile? Of course, as the saying goes, without risk there is no reward.
To get a little perspective I am going to link that entire thread so readers here can see the responses. If this is against board rules I apologize in advance. Also, this should be posted in the alternative forum.
http://www.sjwinfo.org/forum/showthread.php?t=2501
Posted by bulldog2 on November 3, 2009, at 10:09:46
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 3, 2009, at 9:13:30
> > Do not ever take SJW??? I'm sorry. Many many people have had benefit from SJW.
> >
> > SJW is not without side effects, but most studies have shown a mild side effect profile compared to other psychiatric medications. Sure, there are extreme reactions but these may be alergic. I would definately not go so far as to tell nobody to take it.
> >
> > If you are taking other medications it is always prudent to talk to a doctor before starting it.
> >
> >
> >
> > Linkadge
> >
>
>
> This.
>
> That post you provided is one post on a forum of thousands. The overwhelming majority of posters there have had a good or even miraculous experience using the herb. Phrases like, "this changed my life" are quite common.
>
> SJW has been in use for far, far longer than any pharmaceutical medication. It has been used in millions of doses by almost as many people worldwide and has a proven track record of being relatively safe and just as effective as its newer synthetic cousins.
>
> I personally have tried several prescription antidepressants and nothing has come close to the efficacy and ease of use that SJW has provided.
>
> Is it effective? Yes. Very much so. Is anything that is effective going to carry a risk profile? Of course, as the saying goes, without risk there is no reward.
>
> To get a little perspective I am going to link that entire thread so readers here can see the responses. If this is against board rules I apologize in advance. Also, this should be posted in the alternative forum.
>
> http://www.sjwinfo.org/forum/showthread.php?t=2501
>
>
>I disagree on the safety of this med. Many people are no longer taking this herb as the word gets out on its possible link to cataracts. Also its abililty to lower prescription med levels could be potentially life threatening. This med is to potent to be sitting on shelves with vitamins and minerals. Are there any warning on the bottle about these dangers? I didn't say it wasn't a decent ad.
Posted by linkadge on November 3, 2009, at 10:42:26
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 3, 2009, at 6:47:12
How is is connected to cateracts? I knew there was a theoretical link on the basis of photosensitivity. I hadn't heard more than that.
Do you have a study?
Linkadge
Posted by linkadge on November 3, 2009, at 10:47:00
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by bulldog2 on November 3, 2009, at 10:09:46
If it was that unsafe, it would be pulled. Keep in mind, SJW is a very popular herb. Who knows what the exact incidence of side effects are.
The FDA pulled kava kava over comparitivly few reports of liver problems. If SJW was a real risk it would be pulled.
Many SJW products also warn of possible interactions with other medications. This is true for many drugs and herbs.
Grapefruit juice can significantly alter blood levels of many medications. You don't need a prescription for grapfruit juice.
I think the main issue is that anybody who is taking a prescription medicine should check with a doctor before taking a herb. Thats just common sense though that has been advised time and again.
Linkadge
Posted by bulldog2 on November 3, 2009, at 11:23:58
In reply to Re: You Must Use Caution With St. Johns Wort, posted by linkadge on November 3, 2009, at 10:47:00
> If it was that unsafe, it would be pulled. Keep in mind, SJW is a very popular herb. Who knows what the exact incidence of side effects are.
>
> The FDA pulled kava kava over comparitivly few reports of liver problems. If SJW was a real risk it would be pulled.
>
> Many SJW products also warn of possible interactions with other medications. This is true for many drugs and herbs.
>
> Grapefruit juice can significantly alter blood levels of many medications. You don't need a prescription for grapfruit juice.
>
> I think the main issue is that anybody who is taking a prescription medicine should check with a doctor before taking a herb. Thats just common sense though that has been advised time and again.
>
> Linkadge
>
>
>
>Saw one study where cows were fed sjw in their feed. They developed developed cataracts over the period of one year and also horrible skin burns. The hypericin makes the skin very sun sensitive and can easily cause eye damage and skin damage.
You should google this as there should be lots of info out there.
This is beyond anecdotal at this point. I also developed severe cataracts the summer I used sjw. Don't think it was coincidental and it doesn't run in my family.
Not really looking to debate but trying to warn people so they don't experience what happened to me.
This is a little more serious than grapefruit juice. The fact that the fda hasn't gotten to it is not a reason to feel warm and fuzzy.
Buyer beware and consume and your own risk!
Posted by SLS on November 3, 2009, at 12:09:59
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 3, 2009, at 9:13:30
> I personally have tried several prescription antidepressants and nothing has come close to the efficacy and ease of use that SJW has provided.
I have seen it work, too. A woman I know who had a mild to moderate depression reported feeling better on it. However, for a more severe episode, she needed Nardil to obtain a remission. I have not tried SJW. If I had, and it worked, I would be first in line to extol its virtues. As it is, I have not yet come across someone with severe major depressive disorder who has responded well to it. Of course, that doesn't mean very much. If I lived in Germany, perhaps things would be different.
> SJW has been in use for far, far longer than any pharmaceutical medication. It has been used in millions of doses by almost as many people worldwide and has a proven track record of being relatively safe and just as effective as its newer synthetic cousins.
I guess that depends upon whose data and interpretations you place your trust in.
______________________________________________________________________
* I do place a great deal of trust in the National Institutes of Health (NIH):
"The extract from St. John's wort (Hypericum perforatum), a bushy, wild-growing plant with yellow flowers, has been used for centuries in many folk and herbal remedies. Today in Europe, it is used extensively to treat mild to moderate depression. In the United States, it is one of the top-selling botanical products.To address increasing American interests in St. John's wort, the National Institutes of Health conducted a clinical trial to determine the effectiveness of the herb in treating adults who have major depression. Involving 340 patients diagnosed with major depression, the eight-week trial randomly assigned one-third of them to a uniform dose of St. John's wort, one-third to a commonly prescribed SSRI, and one-third to a placebo. The trial found that St. John's wort was no more effective than the placebo in treating major depression.29 Another study is looking at the effectiveness of St. John's wort for treating mild or minor depression.
Other research has shown that St. John's wort can interact unfavorably with other medications, including those used to control HIV infection. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb appears to interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Because of these potential interactions, patients should always consult with their doctors before taking any herbal supplement."
http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml
______________________________________________________________________* I also have the the utmost respect for the following research team:
"J Clin Psychopharmacol. 2005 Oct;25(5):441-7.
A Double-blind, randomized trial of St John's wort, fluoxetine, and placebo in major depressive disorder.Fava M, Alpert J, Nierenberg AA, Mischoulon D, Otto MW, Zajecka J, Murck H, Rosenbaum JF.
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. mfava@partners.org
OBJECTIVE: This study looks to compare the antidepressant efficacy and safety of a standardized extract of St John's wort with both placebo and fluoxetine. METHOD: After a 1-week single-blind washout, patients with major depressive disorder diagnosed by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were randomized to 12 weeks of double-blind treatment with LI-160 St John's wort extract (900 mg/d), fluoxetine (20 mg/d), or placebo. The 17-item Hamilton Rating Scale for Depression (HAMD-17) was the primary efficacy measure, and analysis of covariance was used to compare differences in end point HAMD-17 scores across the 3 treatment groups, treating the baseline HAMD-17 as the covariate. RESULTS: One hundred thirty-five patients (57% women; mean age, 37.3 +/- 11.0; mean HAMD-17, 19.7 +/- 3.2) were randomized to double-blind treatment and were included in the intent-to-treat analyses. Analysis of covariance analyses showed lower mean HAMD-17 scores at end point in the St John's wort group (n = 45; mean +/- SD, 10.2 +/- 6.6) compared with the fluoxetine group (n = 47; 13.3 +/- 7.3; P < 0.03) and a trend toward a similar finding relative to the placebo group (n = 43; 12.6 +/- 6.4; P = 0.096). There was also a trend toward higher rates of remission (HAMD-17 <8) in the St John's wort group (38%) compared with the fluoxetine group (30%) and the placebo group (21%). Overall, St John's wort appeared to be safe and well tolerated. CONCLUSION: St John's wort was significantly more effective than fluoxetine and showed a trend toward superiority over placebo. A (25%) smaller than planned sample size is likely to account for the lack of statistical significance for the advantage (indicating a moderate effect size, d = 0.45) of St John's wort over placebo."
______________________________________________________________________
This study chose subjects whose degrees of depression were rated as moderate-to-severe, although not very severe. I would like to see the full text, as I find the abstract to be confusing and contradictory. Anyway, on the surface, it would seem that the authors report that SJW produces a higher rate of remission than Prozac. However, they also try to account for why the advantage of SJW over placebo did not reach statistical significance. Also, Prozac was not to be as effective as has been demonstrated historically. It might be a failed study. I'm not sure.
- Scott
Posted by TenMan on November 3, 2009, at 14:26:08
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by SLS on November 3, 2009, at 12:09:59
> I guess that depends upon whose data and interpretations you place your trust in.
I was basing my opinion of this Cochrane Review:
Cochrane Database Syst Rev. 2008 Oct 8;(4):CD000448.
St John's wort for major depression.Linde K, Berner MM, Kriston L.
Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universitaet Muenchen, Wolfgangstr. 8, Munich, Germany, 81667.
Comment in:
* Evid Based Ment Health. 2009 Aug;12(3):78.
Update of:
* Cochrane Database Syst Rev. 2005;(2):CD000448.
BACKGROUND: In some countries extracts of the plant Hypericum perforatum L. (popularly called St. John's wort) are widely used for treating patients with depressive symptoms. OBJECTIVES: To investigate whether extracts of hypericum are more effective than placebo and as effective as standard antidepressants in the treatment of major depression; and whether they have fewer adverse effects than standard antidepressant drugs. SEARCH STRATEGY: Trials were searched in computerised databases, by checking bibliographies of relevant articles, and by contacting manufacturers and researchers. SELECTION CRITERIA: Trials were included if they: (1) were randomised and double-blind; (2) included patients with major depression; (3) compared extracts of St. John's wort with placebo or standard antidepressants; (4) included clinical outcomes assessing depressive symptoms. DATA COLLECTION AND ANALYSIS: At least two independent reviewers extracted information from study reports. The main outcome measure for assessing effectiveness was the responder rate ratio (the relative risk of having a response to treatment). The main outcome measure for adverse effects was the number of patients dropping out due to adverse effects. MAIN RESULTS: A total of 29 trials (5489 patients) including 18 comparisons with placebo and 17 comparisons with synthetic standard antidepressants met the inclusion criteria. Results of placebo-controlled trials showed marked heterogeneity. In nine larger trials the combined response rate ratio (RR) for hypericum extracts compared with placebo was 1.28 (95% confidence interval (CI), 1.10 to 1.49) and from nine smaller trials was 1.87 (95% CI, 1.22 to 2.87). Results of trials comparing hypericum extracts and standard antidepressants were statistically homogeneous. Compared with tri- or tetracyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), respectively, RRs were 1.02 (95% CI, 0.90 to 1.15; 5 trials) and 1.00 (95% CI, 0.90 to 1.11; 12 trials). Both in placebo-controlled trials and in comparisons with standard antidepressants, trials from German-speaking countries reported findings more favourable to hypericum. Patients given hypericum extracts dropped out of trials due to adverse effects less frequently than those given older antidepressants (odds ratio (OR) 0.24; 95% CI, 0.13 to 0.46) or SSRIs (OR 0.53, 95% CI, 0.34-0.83). AUTHORS' CONCLUSIONS: The available evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation.
Posted by TenMan on November 3, 2009, at 14:38:04
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 3, 2009, at 11:23:58
> > If it was that unsafe, it would be pulled. Keep in mind, SJW is a very popular herb. Who knows what the exact incidence of side effects are.
> >
> > The FDA pulled kava kava over comparitivly few reports of liver problems. If SJW was a real risk it would be pulled.
> >
> > Many SJW products also warn of possible interactions with other medications. This is true for many drugs and herbs.
> >
> > Grapefruit juice can significantly alter blood levels of many medications. You don't need a prescription for grapfruit juice.
> >
> > I think the main issue is that anybody who is taking a prescription medicine should check with a doctor before taking a herb. Thats just common sense though that has been advised time and again.
> >
> > Linkadge
> >
> >
> >
> >
>
> Saw one study where cows were fed sjw in their feed. They developed developed cataracts over the period of one year and also horrible skin burns. The hypericin makes the skin very sun sensitive and can easily cause eye damage and skin damage.
> You should google this as there should be lots of info out there.
> This is beyond anecdotal at this point. I also developed severe cataracts the summer I used sjw. Don't think it was coincidental and it doesn't run in my family.
> Not really looking to debate but trying to warn people so they don't experience what happened to me.
> This is a little more serious than grapefruit juice. The fact that the fda hasn't gotten to it is not a reason to feel warm and fuzzy.
> Buyer beware and consume and your own risk!Feeding cows SJW is in no way an accurate effect of what taking standardized doses will do to a human. Please post this cow study so we can gauge how much they were ingesting.
Nothing bothers me more than when some do-gooder comes along and wants to regulate and restrict something from me that they deem hurtful. If you have anything that actually shows something worth reading that is not anecdote, please post it. As for now, all I see from you is hand-waiving and hysteria.
Posted by metafunj on November 3, 2009, at 14:53:17
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 3, 2009, at 14:38:04
Interesting I posted in this thread before this study was even mentioned that I had gotten sun burn from SJW.
Posted by TenMan on November 3, 2009, at 14:59:13
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by metafunj on November 3, 2009, at 14:53:17
> Interesting I posted in this thread before this study was even mentioned that I had gotten sun burn from SJW.
Mild photosensitivity is a well known side effect of SJW. Third degree burns, cataracts and the like are not. Is it possible? Sure, I don't discount that at all. However, I haven't seen anything documented beyond mild sensitivities in the literature. I myself do get burned more easily but that is a minor side effect for the benefits it has brought to me. I have taken SJW for years so I'm well aware of what it can do for me personally.
Posted by bulldog2 on November 3, 2009, at 15:09:46
In reply to Re: You Must Use Caution With St. Johns Wort » metafunj, posted by TenMan on November 3, 2009, at 14:59:13
> > Interesting I posted in this thread before this study was even mentioned that I had gotten sun burn from SJW.
>
> Mild photosensitivity is a well known side effect of SJW. Third degree burns, cataracts and the like are not. Is it possible? Sure, I don't discount that at all. However, I haven't seen anything documented beyond mild sensitivities in the literature. I myself do get burned more easily but that is a minor side effect for the benefits it has brought to me. I have taken SJW for years so I'm well aware of what it can do for me personally.
>
>
>Here is a list of side effects from a well known sjw site who is very pro sjw. There is a lot of good information if you go into the main site.
Posted by TenMan on November 3, 2009, at 15:14:12
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 3, 2009, at 15:09:46
>
> Here is a list of side effects from a well known sjw site who is very pro sjw. There is a lot of good information if you go into the main site.
>
> http://www.sjwinfo.org/sideeffects.phpThank you for the link, but I am well aware of that site. I actually posted a link to it earlier in this very thread, if you had read my posts.
Now, do you actually have anything in the literature to substantiate your claim that SJW can cause massive burns and cataracts among users taking the standardized dosages? Preliminary research and anecdote aside, is there anything that warrants the alarmist tone of your posts?
Posted by bulldog2 on November 3, 2009, at 15:27:26
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 3, 2009, at 14:26:08
>
>
> > I guess that depends upon whose data and interpretations you place your trust in.
>
>
> I was basing my opinion of this Cochrane Review:
>
> Cochrane Database Syst Rev. 2008 Oct 8;(4):CD000448.
> St John's wort for major depression.
>
> Linde K, Berner MM, Kriston L.
>
> Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universitaet Muenchen, Wolfgangstr. 8, Munich, Germany, 81667.
>
> Comment in:
>
> * Evid Based Ment Health. 2009 Aug;12(3):78.
>
> Update of:
>
> * Cochrane Database Syst Rev. 2005;(2):CD000448.
>
> BACKGROUND: In some countries extracts of the plant Hypericum perforatum L. (popularly called St. John's wort) are widely used for treating patients with depressive symptoms. OBJECTIVES: To investigate whether extracts of hypericum are more effective than placebo and as effective as standard antidepressants in the treatment of major depression; and whether they have fewer adverse effects than standard antidepressant drugs. SEARCH STRATEGY: Trials were searched in computerised databases, by checking bibliographies of relevant articles, and by contacting manufacturers and researchers. SELECTION CRITERIA: Trials were included if they: (1) were randomised and double-blind; (2) included patients with major depression; (3) compared extracts of St. John's wort with placebo or standard antidepressants; (4) included clinical outcomes assessing depressive symptoms. DATA COLLECTION AND ANALYSIS: At least two independent reviewers extracted information from study reports. The main outcome measure for assessing effectiveness was the responder rate ratio (the relative risk of having a response to treatment). The main outcome measure for adverse effects was the number of patients dropping out due to adverse effects. MAIN RESULTS: A total of 29 trials (5489 patients) including 18 comparisons with placebo and 17 comparisons with synthetic standard antidepressants met the inclusion criteria. Results of placebo-controlled trials showed marked heterogeneity. In nine larger trials the combined response rate ratio (RR) for hypericum extracts compared with placebo was 1.28 (95% confidence interval (CI), 1.10 to 1.49) and from nine smaller trials was 1.87 (95% CI, 1.22 to 2.87). Results of trials comparing hypericum extracts and standard antidepressants were statistically homogeneous. Compared with tri- or tetracyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), respectively, RRs were 1.02 (95% CI, 0.90 to 1.15; 5 trials) and 1.00 (95% CI, 0.90 to 1.11; 12 trials). Both in placebo-controlled trials and in comparisons with standard antidepressants, trials from German-speaking countries reported findings more favourable to hypericum. Patients given hypericum extracts dropped out of trials due to adverse effects less frequently than those given older antidepressants (odds ratio (OR) 0.24; 95% CI, 0.13 to 0.46) or SSRIs (OR 0.53, 95% CI, 0.34-0.83). AUTHORS' CONCLUSIONS: The available evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. The association of country of origin and precision with effects sizes complicates the interpretation.
>
>I cannot find the dose of the antidepressnats used. If they are in the data could you show me. The dosages I saw in one study were 40 mg of immipramine. The therapeutic dose is around 150 mg. Certainly not 40 mg. I
Posted by SLS on November 3, 2009, at 17:19:38
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 3, 2009, at 14:26:08
> I was basing my opinion of this Cochrane Review:
Yes. The Cochrane review is often referred to. However, it is really little more than a literature review, and there is not very much sound scientific investigation in the literature available to review. I would rather scrutinize the individual experiments than assume their validity. My current belief is that the efficacy of SJW is often exaggerated.
- Scott
Posted by linkadge on November 3, 2009, at 17:33:38
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 3, 2009, at 11:23:58
>Saw one study where cows were fed sjw in their >feed. They developed developed cataracts over >the period of one year and also horrible skin >burns. The hypericin makes the skin very sun >sensitive and can easily cause eye damage and >skin damage.
Yeah, I don't know if I buy that study. The first thing is dose - just how much were the cows fed? I have read other animal studies refuting the notion that SJW could cause significant photosensitivity in clinical doses.
>This is beyond anecdotal at this point. I also >developed severe cataracts the summer I used sjw.
Yeah, I just did a google search and certainly didn't come across anything I would consider conclusive. Lamotrigine and seroquel have been linked to possible cateract development too. But again, these are animal toxicological studies where they are fed many hundreds times the upper human limit.
>This is a little more serious than grapefruit >juice. The fact that the fda hasn't gotten to it >is not a reason to feel warm and fuzzy.
Actually, I don't think it is more serious than grapefruit juice personally. Grapefruit juice can significantly alter the metabolism of many medications.
In germany SJW is (or was) the most prescribed antidepressant - and had far fewer adverse drug reports than the next leadning SSRI's.
There are adverse reactions to many herbal products and if you just do a google search you can find something on pretty any herb.
In the grand scheme though I don't think there is any great risk to the population at large.
What medications were you taking with SJW? SJW should never be taken with other antidepressants, or stimulants. I think that is asking for serotoning syndrome.
Linkadge
Posted by linkadge on November 3, 2009, at 17:35:33
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 3, 2009, at 11:23:58
So if you had this big "adverse reaction" to SJW, why are we only hearing about it now - a year later?
Were you taking other medications at the time?
Linkadge
Posted by linkadge on November 3, 2009, at 17:37:11
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by SLS on November 3, 2009, at 12:09:59
SLS, I think that was the study where SJW was compared to zoloft and placebo. Both zoloft and SJW were less effective than the placebo and zoloft was less effective than SJW.
Linkadge
Posted by linkadge on November 3, 2009, at 17:39:28
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by metafunj on November 3, 2009, at 14:53:17
You get sun burns from the sun. Just because somebody got a sunburn while taking SJW does not prove that SJW was responsible.
The whole increased photosensitivity thing is pretty much theoretical IMHO. I don't know of any study which proves increased photosensitivity while taking SJW at clinical doses.
Linkadge
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.