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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by morganator on November 28, 2009, at 23:34:47
I have heard of people taking SJW with an antidepressant. Actually, I just read of one particular case where someone takes SJW with Zoloft. I know there is evidence that SJW inhibits the uptake of serotonin, dopamine, and norepinephrine. This would lead me to believe that one should not take SJW with any antidepressant. I want to experiment with a low dose but I'm a bit weary.
Posted by Phillipa on November 29, 2009, at 0:24:45
In reply to Combining SJW with Zoloft or other antidepressants, posted by morganator on November 28, 2009, at 23:34:47
Low dose of both? Maybe Phillipa
Posted by manic666 on November 29, 2009, at 3:14:45
In reply to Re: Combining SJW with Zoloft or other antidepressants » morganator, posted by Phillipa on November 29, 2009, at 0:24:45
you will distroy your self, jesus sj wart is a no with any antidpressant,its the fist rule of meds.tell a doc what you want to do an see his reaction.
Posted by bulldog2 on November 29, 2009, at 13:34:18
In reply to Combining SJW with Zoloft or other antidepressants, posted by morganator on November 28, 2009, at 23:34:47
> I have heard of people taking SJW with an antidepressant. Actually, I just read of one particular case where someone takes SJW with Zoloft. I know there is evidence that SJW inhibits the uptake of serotonin, dopamine, and norepinephrine. This would lead me to believe that one should not take SJW with any antidepressant. I want to experiment with a low dose but I'm a bit weary.
You could get serotonin syndrome.
Posted by bleauberry on November 29, 2009, at 14:09:11
In reply to Combining SJW with Zoloft or other antidepressants, posted by morganator on November 28, 2009, at 23:34:47
For about 3 months I took SJW Kira brand 600mg (300mg twice a day) with ongoing 20mg Prozac and 5mg Zyprexa. It felt weird the first couple weeks, but when it started to kick in it was amazing. No serotonin syndrome problems.
I believe an SSRI and SJW go well together, but doses should be modest. High doses of both would probably be inviting risk.
The combo of Prozac and SJW was fine.
In literature SJW has increased plasma levels of Zyprexa by 300%. That was a problem for me.
I believe serotonin sydrome is not a big risk, but then, people have gotten serotonin sydrome on a single med like Lexapro without any combinations at all. So you never know. I was cautious by starting with 75mg SJW (custom cutting pills) and increasing about every 4 days.
Posted by bulldog2 on November 29, 2009, at 14:32:59
In reply to Re: Combining SJW with Zoloft or other antidepressants, posted by bleauberry on November 29, 2009, at 14:09:11
> For about 3 months I took SJW Kira brand 600mg (300mg twice a day) with ongoing 20mg Prozac and 5mg Zyprexa. It felt weird the first couple weeks, but when it started to kick in it was amazing. No serotonin syndrome problems.
>
> I believe an SSRI and SJW go well together, but doses should be modest. High doses of both would probably be inviting risk.
>
> The combo of Prozac and SJW was fine.
>
> In literature SJW has increased plasma levels of Zyprexa by 300%. That was a problem for me.
>
> I believe serotonin sydrome is not a big risk, but then, people have gotten serotonin sydrome on a single med like Lexapro without any combinations at all. So you never know. I was cautious by starting with 75mg SJW (custom cutting pills) and increasing about every 4 days.I know of a man who died of serotonin syndrome when he combined sjw with effexor. I have no idea what his doses were. It's hard to predict at what dose the combo could become dangerous or what constitutes low dose. Better to be safe than sorry.
Posted by morganator on November 29, 2009, at 15:05:04
In reply to Re: Combining SJW with Zoloft or other antidepressants, posted by bleauberry on November 29, 2009, at 14:09:11
I would have normally said no way to combining SJW with an SSRI. Then I heard some accounts of people having success with it.
Blueaberry, are you still taking SJW? If you were feeling that good on Prozac and SJW why did you stop? I understand that you have Lyme disease but isn't SJW good for lyme?
Another question about Lyme, do you take lithium orotate? I have read that lithium can be good for lyme.
Posted by morganator on November 29, 2009, at 15:38:03
In reply to Re: Combining SJW with Zoloft or other antidepressants, posted by bleauberry on November 29, 2009, at 14:09:11
Bleauberry, If I want to try combining a low dose of SJW with Zoloft, do you think it would be wise to lower the dose of Zoloft?
I really feel like I should just stop taking Zoloft if 200mgs doesn't give me what I need and start trying SJW. It's either that or switch to Prozac, which I had success with in the past.
Posted by bulldog2 on November 29, 2009, at 16:05:18
In reply to Re: Combining SJW with Zoloft or other antidepressants » bleauberry, posted by morganator on November 29, 2009, at 15:38:03
> Bleauberry, If I want to try combining a low dose of SJW with Zoloft, do you think it would be wise to lower the dose of Zoloft?
>
> I really feel like I should just stop taking Zoloft if 200mgs doesn't give me what I need and start trying SJW. It's either that or switch to Prozac, which I had success with in the past.Really depends how severe your depression is. SJW is not effective for moderate to severe depression. It often works for mild depression. It's basically a weak ssri even though it has some effects on dopamine and norepinephrine. Mixing is not a good idea. Maybe you can get away with it if you're on 25 mg of zoloft. SJW also screws with blood levels of meds. That can be dangerous.If you use sjw than go all natural. Mix it with sam-e or 5htp.
Posted by bleauberry on November 30, 2009, at 18:34:45
In reply to Re: Combining SJW with Zoloft or other antidepressants » bleauberry, posted by morganator on November 29, 2009, at 15:38:03
> Bleauberry, If I want to try combining a low dose of SJW with Zoloft, do you think it would be wise to lower the dose of Zoloft?
>
> I really feel like I should just stop taking Zoloft if 200mgs doesn't give me what I need and start trying SJW. It's either that or switch to Prozac, which I had success with in the past.Yikes, that's a tough decision. If I were in your shoes, that would be a difficult decision for me. There are pros and cons either way. Potential benefits and potential risks either way. And unknowns both ways.
Well, let's see, let me logic this out. First of all, switching any SSRI is no picnic. Hard as hell. So right off the bat, I would say stay on Zoloft. My next decision would be, do I lower the dose? I would probably say yes, but by how much, 25mg or 50mg? Longer term as SJW kicks in, 100mg?
Either way, I know there is going to be some weirdness for a couple weeks after doing that. So if I start the SJW in that timeframe, I really won't know what the weirdness is coming from...the lowered Zoloft or the added SJW. How much SJW to add? That's easy. No more than 75mg for at least 4 days. Then add 75mg once every 4 to 7 days as tolerated, as the gut intuition directs, with a top ceiling of 450mg. After being at 450mg for at least 2 weeks, it could be increased by 75mg increments to a top ceiling of 600mg.
But that's just me. I am cautious and methodical. Someone else might do it different, but likely experience potential for a lot more complications than me. Complications that could have been avoided by not getting greedy or going too fast.
We are after all playing with the brain here.
On the other hand, if Prozac was better, well, it would be nice to see if it still can do it again...sometimes it doesn't a second time around, sometimes it does. Either way, add SJW to it in the same manner described above. The downfall with this approach is that it would take a lot more time and have a lot more complications. Switching like that aint easy. I mean, you could do a straight across switch with maybe just two days of washout, but still, there would be a lot of weirdness...Zoloft withdrawals mixed with Prozac startups all in a dizzying confusion.
Another more mainstreet approach that has an excellent track record would be to add Nortriptyline to Zoloft. Nortriptyline doses needed for that can be as low as 10mg, but usually in the 25mg to 75mg range, still far below the high doses used as monotherapy. Zoloft and Nortriptyline is almost as good, and sometimes better, than the MAOIs.
Posted by morganator on November 30, 2009, at 20:31:43
In reply to Re: Combining SJW with Zoloft or other antidepressants, posted by bleauberry on November 30, 2009, at 18:34:45
Wow thanks so much for all of the detailed advice. Yeah I assumed that if I added SJW I would have to lower the dose of Zoloft to 100mgs(where I used to be at when I just took Zoloft and nothing else). I took myself off Zoloft after 7 years thinking I didn't need medication anymore and 6 months later the perfect storm of events plus not being on medication sent me into a severe mixed manic episode. After a year and a half of being on 11 different medications I have struggled with depression and anxiety worse than ever and my brain feels like it's been through the ringer.
I currently take depakote and zyprexa with the 200 mgs. I am weening off zyprexa now and am down to less than 2.5 mg. I only just started 200 mg Zoloft a week ago so I think I might give that some time.
Nortriptyline definitely interests me. I wonder if anyone takes it in the morning instead of at night. I only hear of people taking it at night time.
I kinda feel like switching back to Prozac after 11 years may be a good thing since my brain might need something new and different. Then again it may not work like it did before because my brain has gone through some changes. Ya know it's funny, the first time I took Prozac I was 22(I realize now that I was having my first mixed episode) and it was truly amazing. After the first 3 weeks of not feeling anything from it I woke up one day, took my little pill, and withing an hour I had felt better than I had in years. I was the person I always wanted to be. Prozac was like an antidepressant and mood stabilizer in one pill. I had my manic moments mainly if I drank too much, but for the most part I felt very even keeled and slept great. Zoloft was the same for me for some of the time I was on it also. Oh well, times and conditions have changed unfortunately.
So when you say SJW and Prozac were amazing what exactly do you mean? Did you get relief from anxiety as well as depression? Did you even have anxiety?
This is the end of the thread.
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