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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by KaraS on January 10, 2005, at 16:51:19
I need to start on something quickly and I can't seem to make up my mind. I'd rather be on something more natural but I wonder if SJW is strong enough for fairly severe depression. I am in the process of increasing my fish oil and could augment the SJW with some other things as well. Is this an ok choice for me now?
Those of you who were helped by SJW, was your depression beyond mild to moderate?
Kara
Posted by zmg on January 10, 2005, at 20:27:36
In reply to SJW ok for severe depression?, posted by KaraS on January 10, 2005, at 16:51:19
I'm looking at Stablon (just to complicate things more). It's a French pharmaceutical made by Servier in a class mostly by itself (SSRA: Selective Serotonin Reuptake Accelerator). I realize its not an immediate solution, but it looks like a potentially exciting one (and you seem interested in this sort of thing).
http://www.servier.com/pro/Neurosciences/stablon/stablon_press.asp
Posted by KaraS on January 10, 2005, at 21:59:34
In reply to Re: SJW ok for severe depression?, posted by zmg on January 10, 2005, at 20:27:36
> I'm looking at Stablon (just to complicate things more). It's a French pharmaceutical made by Servier in a class mostly by itself (SSRA: Selective Serotonin Reuptake Accelerator). I realize its not an immediate solution, but it looks like a potentially exciting one (and you seem interested in this sort of thing).
>
> http://www.servier.com/pro/Neurosciences/stablon/stablon_press.asp
I've read a little bit about it. I think Jasmineroli was really interested in that as well. Let me know how you do on it.Kara
Posted by zmg on January 10, 2005, at 23:02:18
In reply to Re: SJW ok for severe depression? » zmg, posted by KaraS on January 10, 2005, at 21:59:34
This stuff has always made me like a kid at a candy store. I sure will let you know what I think.
Tried the Taurine (helped, but without any mood lifting) and placed a fairly large order from BAC (Niacinamide, Chocamine, Ashwaghanda, Rhodiola rosea, Picamilon, Bacopa, etc) too. LOL.
Hope your feeling well (and thanks for all your posts here..really!).
Zach
Posted by jujube on January 11, 2005, at 0:14:30
In reply to SJW ok for severe depression?, posted by KaraS on January 10, 2005, at 16:51:19
Kara,
I am sorry you are still struggling with your decision. But it is a big decision, and you are wise to take the time needed to ensure that you are comfortable with whichever path you chose.
I have never really tried SJW, so I can not answer your question. Did you have a look at BarbaraCat's post above? She mentions that SJW is not just for mild to moderate depression, and goes on to detail her experience with it, including which brands she uses.
I seem to recall Larry posting a summary of a study or something about SJW that compared its effectiveness to that of a TCA (then again, I am sleep deprived these days, so I may not be remembering correctly at all). Unfortunately, I can't seem to execute the PB search function in order to find the post. Hopefully Larry will respond as well.
Sorry I couldn't be more helpful. Take care of yourself.
Tamara
> I need to start on something quickly and I can't seem to make up my mind. I'd rather be on something more natural but I wonder if SJW is strong enough for fairly severe depression. I am in the process of increasing my fish oil and could augment the SJW with some other things as well. Is this an ok choice for me now?
>
> Those of you who were helped by SJW, was your depression beyond mild to moderate?
>
> Kara
Posted by KaraS on January 11, 2005, at 3:21:04
In reply to Re: SJW ok for severe depression?, posted by zmg on January 10, 2005, at 23:02:18
> This stuff has always made me like a kid at a candy store. I sure will let you know what I think.
>
> Tried the Taurine (helped, but without any mood lifting) and placed a fairly large order from BAC (Niacinamide, Chocamine, Ashwaghanda, Rhodiola rosea, Picamilon, Bacopa, etc) too. LOL.
>
> Hope your feeling well (and thanks for all your posts here..really!).
>
> Zach
Looks like you have your work cut out for you. I've only tried about half of those things. I'm very curious to see how it all works for you. Just don't take too many at once so that you can't tell what's doing what!K
Posted by KaraS on January 11, 2005, at 3:29:38
In reply to Re: SJW ok for severe depression? » KaraS, posted by jujube on January 11, 2005, at 0:14:30
Thanks. That did help alot. I had reread BarbaraCat's posts but somehow I missed that one by Larry. Your message steered me to it. Now hopefully I'll make up my mind in the next day or two.
Have you met with your doctor yet or is that later this week?
> Kara,
>
> I am sorry you are still struggling with your decision. But it is a big decision, and you are wise to take the time needed to ensure that you are comfortable with whichever path you chose.
>
> I have never really tried SJW, so I can not answer your question. Did you have a look at BarbaraCat's post above? She mentions that SJW is not just for mild to moderate depression, and goes on to detail her experience with it, including which brands she uses.
>
> I seem to recall Larry posting a summary of a study or something about SJW that compared its effectiveness to that of a TCA (then again, I am sleep deprived these days, so I may not be remembering correctly at all). Unfortunately, I can't seem to execute the PB search function in order to find the post. Hopefully Larry will respond as well.
>
> Sorry I couldn't be more helpful. Take care of yourself.
>
> Tamara
>> > I need to start on something quickly and I can't seem to make up my mind. I'd rather be on something more natural but I wonder if SJW is strong enough for fairly severe depression. I am in the process of increasing my fish oil and could augment the SJW with some other things as well. Is this an ok choice for me now?
> >
> > Those of you who were helped by SJW, was your depression beyond mild to moderate?
> >
> > Kara
>
>
Posted by zmg on January 11, 2005, at 3:41:34
In reply to Re: SJW ok for severe depression? » zmg, posted by KaraS on January 11, 2005, at 3:21:04
Duely noted! =)
Posted by jujube on January 11, 2005, at 23:02:23
In reply to Re: SJW ok for severe depression? » jujube, posted by KaraS on January 11, 2005, at 3:29:38
Hi Kara!
Have you met with your doctor yet or is that later this week?
I have had three appointments with the "witch" doctor. You are kind to ask. I have to say that he is very interesting! His clinic is packed with patients who are there to see him for treatment of all kinds of diseases and disorders (even cancer, I think). I have learned that even doctors in my city who are trained only in western medicine go to him for treatment. That certainly is a testament to his skill as a clinician. Anyway, the three sessions I had with him were very short and were aimed at reducing the pain and swelling in my wrist and hand. After the first treatment, I experienced tremendous relief, and was actually able to bend my fingers without pain shooting up through my arm. His clinic will be closed towards the end of January until March. He wants to see me again in March to deal with the deficiencies he says I have (iron, which I already knew, B-1, Calcium and maybe B-12). He says he is going to put the sparkle and life back in my eyes. And, I see the surgeon for a follow-up about my wrist tomorrow.
Enough about me. I hope you are hanging in there. I will be thinking about you as you wrestle with your decision to MAOI or not to MAOI.
Take good care.
Tamara
Posted by KaraS on January 12, 2005, at 0:59:29
In reply to Re: SJW ok for severe depression? » KaraS, posted by jujube on January 11, 2005, at 23:02:23
> Hi Kara!
>
> Have you met with your doctor yet or is that later this week?
>
> I have had three appointments with the "witch" doctor. You are kind to ask. I have to say that he is very interesting! His clinic is packed with patients who are there to see him for treatment of all kinds of diseases and disorders (even cancer, I think). I have learned that even doctors in my city who are trained only in western medicine go to him for treatment. That certainly is a testament to his skill as a clinician. Anyway, the three sessions I had with him were very short and were aimed at reducing the pain and swelling in my wrist and hand. After the first treatment, I experienced tremendous relief, and was actually able to bend my fingers without pain shooting up through my arm. His clinic will be closed towards the end of January until March. He wants to see me again in March to deal with the deficiencies he says I have (iron, which I already knew, B-1, Calcium and maybe B-12). He says he is going to put the sparkle and life back in my eyes. And, I see the surgeon for a follow-up about my wrist tomorrow.
>
> Enough about me. I hope you are hanging in there. I will be thinking about you as you wrestle with your decision to MAOI or not to MAOI.
>
> Take good care.
>
> Tamara
>Tamara,
He really does sound fascinating. That's impressive about your wrist improvement! If he can take away the anxiety and depression then I'll really be sold. I'm just bummed we have to wait until March to find out. What bad timing!
Kara
P.S. I think I've decided against the MAOI for now. I don't feel comfortable taking one while I don't have health insurance. It's too risky for me. Hopefully, the EMSAM patch will come out soon and I'll have that option instead.
Posted by jujube on January 12, 2005, at 22:59:45
In reply to Re: SJW ok for severe depression? » jujube, posted by KaraS on January 12, 2005, at 0:59:29
If he can take away the anxiety and depression then I'll really be sold.
-- I am hoping the treatments can help with those things too. I intend to raise it with him in March. I am tired of struggling and trying to hide the way I am feeling from everyone with a smile on my face and jokes. I have been doing everything the doctors have been telling me to do (exercise, which I did daily anyways, eating better, changing the "tapes", etc.). Perhaps a little voodoo along with the right med and natural supplements will work. If not, c'est la vie!
I'm just bummed we have to wait until March to find out. What bad timing!-- Me too!
> Kara
>
> P.S. I think I've decided against the MAOI for now. I don't feel comfortable taking one while I don't have health insurance. It's too risky for me. Hopefully, the EMSAM patch will come out soon and I'll have that option instead.
>
-- I'm so sorry that personal circumstances have forced your decision. I think I would make the same decision if I were in your shoes though. I, too, would not be comfortable taking a med that carried with it potentially serious health risks without adequate access to good health care. It would just increase the anxiety (which would kind of defeat one of the purposes of taking it in the first place). So, do you think you will try Effexor again with an augmenter?Well, you take care. I will be talking to you again soon I'm sure (or at least I hope).
Tamara
Posted by KaraS on January 16, 2005, at 1:01:24
In reply to Re: SJW ok for severe depression? » KaraS, posted by jujube on January 12, 2005, at 22:59:45
> If he can take away the anxiety and depression then I'll really be sold.
>
> -- I am hoping the treatments can help with those things too. I intend to raise it with him in March. I am tired of struggling and trying to hide the way I am feeling from everyone with a smile on my face and jokes. I have been doing everything the doctors have been telling me to do (exercise, which I did daily anyways, eating better, changing the "tapes", etc.). Perhaps a little voodoo along with the right med and natural supplements will work. If not, c'est la vie!
You must be incredibly strong. I don't think I could hide how I'm doing right now.
> I'm just bummed we have to wait until March to find out. What bad timing!
>
> -- Me too!
>
> > Kara
> >
> > P.S. I think I've decided against the MAOI for now. I don't feel comfortable taking one while I don't have health insurance. It's too risky for me. Hopefully, the EMSAM patch will come out soon and I'll have that option instead.
> >
> -- I'm so sorry that personal circumstances have forced your decision. I think I would make the same decision if I were in your shoes though. I, too, would not be comfortable taking a med that carried with it potentially serious health risks without adequate access to good health care. It would just increase the anxiety (which would kind of defeat one of the purposes of taking it in the first place). So, do you think you will try Effexor again with an augmenter?
Probably. I'm just so tired of agonizing over it. It will be a huge relief just to start on something. When do you see your doctor about the Provigil? Are your supplements helping again now that you're off of the pain medication?
> Well, you take care. I will be talking to you again soon I'm sure (or at least I hope).
>
> Tamara
I hope your hand is continuing to improve. I'll definitely talk to you later.Kara
Posted by jujube on January 16, 2005, at 14:47:24
In reply to Re: SJW ok for severe depression? » jujube, posted by KaraS on January 16, 2005, at 1:01:24
> You must be incredibly strong. I don't think I could hide how I'm doing right now.-- I don't feel that strong these days. It's been a year of one setback after another, and that has really taken it's toll on me. But, the way I look at it is that there are people who have been through, and continue to go through, much more than I am or ever have. So, I'm trying to stay off the "pity pot" and focus on getting through this and back to the life I am used to living.
>
> Probably. I'm just so tired of agonizing over it. It will be a huge relief just to start on something. When do you see your doctor about the Provigil? Are your supplements helping again now that you're off of the pain medication?
>
-- It is an agonizing decision. From my own experience this past year, I found that the trials and the inadequate responses can really exacerabate the depression and anxiety. But, you already know that Effexor helped you when you used it before, so that's something positive to hold on to. Then, all you have to focus on is identifying an effective augmenter. In any event, I will be thinking of you as you struggle to make your decision.I see the pdoc on Thursday, and will do my best to make a case for Provigil. If he won't go for that, then I will insist on nortriptyline. I have read some positive things about nortriptyline, so I think I would be comfortable taking it. I haven't been very diligent about taking my supplements. I also haven't been able to eat much since the surgery and have been relying on meal replacement shakes (Ensure) to keep me going. So, these things have certainly had a further effect on me. I'll get back into my routine soon I'm sure.
>
>
> I hope your hand is continuing to improve. I'll definitely talk to you later.
>
-- Thanks Kara. The pain and discomfort has subsided significantly, and I am able to sleep a bit better. The past day or so I have really been catching up on my sleep, and that has made me feel a bit better. I miss being able to get out for long walks, but the roads and sidewalks are so icy (we've had a lot of freezing rain and normal rain followed by very cold temperatures this winter) it's hard to get out. Oh well, this lousy weather can't go on forever. Anyway, the way I look at it is that things can only get better and I have to continue to believe that.You take care of yourself, and I'll talk to you soon.
Tamara
Posted by Larry Hoover on February 14, 2005, at 18:01:12
In reply to SJW ok for severe depression?, posted by KaraS on January 10, 2005, at 16:51:19
> I need to start on something quickly and I can't seem to make up my mind. I'd rather be on something more natural but I wonder if SJW is strong enough for fairly severe depression. I am in the process of increasing my fish oil and could augment the SJW with some other things as well. Is this an ok choice for me now?
>
> Those of you who were helped by SJW, was your depression beyond mild to moderate?
>
> KaraYes, SJW works in severe depression. For some obtuse reason, it has only once been tested for that. Note the doses are twice the typical dose, which is quite in line with expectations of dose-responsivity. LI 160 is Jarsin/Kira.
Pharmacopsychiatry. 1997 Sep;30 Suppl 2:81-5.
Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10.
Vorbach EU, Arnoldt KH, Hubner WD.
Department of Psychiatry and Psychotherapy, Ev. Krankenhaus Elisabethenstift, Darmstadt, Germany.
The special extract of St. John's wort, LI 160, exhibited a superior antidepressant efficacy compared to placebo in several controlled trials. Two further trials demonstrated a similar reduction of depressive symptomatology under LI 160 compared to tricyclics. All these trials were performed in mildly to moderately depressed patients. The present investigation was a randomized, controlled, multicentre, 6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in severely depressed patients according to ICD-10. The main efficacy parameter, a reduction of the total score of the Hamilton Depression Scale, proved both treatment regimens very effective at the end of the 6 week treatment period (mean values 25.3 to 14.5 in the LI 160 group and 26.1 to 13.6 in the imipramine group), but not statistically equivalent within a a-priori defined 25% interval of deviation. The analysis of subgroups with more than a 33% and 50% reduction of the HAMD total score justified the assumption of equivalence within a 25% deviation interval. This view was also supported by the global efficacy ratings from patients and investigators. Regarding adverse events, the nonrejection of the nonequivalence hypothesis denotes a superiority of the herbal antidepressant. These main result indicate that LI 160 might be a treatment alternative to the synthetic tricyclic antidepressant imipramine in the majority of severe forms of depressions. However, more studies of this type must be performed before a stronger recommendation can be made.
Sorry for answering late.Lar
Posted by KaraS on February 14, 2005, at 18:22:46
In reply to Re: SJW ok for severe depression? » KaraS, posted by Larry Hoover on February 14, 2005, at 18:01:12
Thanks Lar for the response. One more quick question: I am now taking 25. mg. doxepin for anxiety. It's working really well and I don't dare go off of it right now. Could I try adding SJW to that small amount of a tricyclic or do you think that would be contraindicated?
Hope all is well with you and that your arm is healing.
K
Posted by Larry Hoover on February 14, 2005, at 22:21:36
In reply to Re: SJW ok for severe depression? » Larry Hoover, posted by KaraS on February 14, 2005, at 18:22:46
> Thanks Lar for the response. One more quick question: I am now taking 25. mg. doxepin for anxiety. It's working really well and I don't dare go off of it right now. Could I try adding SJW to that small amount of a tricyclic or do you think that would be contraindicated?
I'm currently taking SJW and a similar dose of a tricyclic (trimipramine). I wouldn't worry about it at all.
> Hope all is well with you and that your arm is healing.
> KMy arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery. Nerve damage flaring up. I had a bad feeling about this the moment it happened. Some intuition is true.
Lar
Posted by KaraS on February 14, 2005, at 23:49:50
In reply to Re: SJW ok for severe depression? » KaraS, posted by Larry Hoover on February 14, 2005, at 22:21:36
> I'm currently taking SJW and a similar dose of a tricyclic (trimipramine). I wouldn't worry about it at all.Thanks. You must have just started the SJW again. What brand are you taking and what dosage? I'm thinking of trying the HBC Protocols brand. Do you think that if one goes past the 900 mg. amount (or esp. if they take as much as 1800 mg.) that they'd need to watch their tyramine intake?
> > Hope all is well with you and that your arm is healing.
> > K
>
> My arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery. Nerve damage flaring up. I had a bad feeling about this the moment it happened. Some intuition is true.
>
> Lar
I was afraid that might be the problem. I'm so sorry to hear that. Hopefully the surgery will correct the problem. Intuition is often correct. Yours certainly was. The trouble is determining what is intuition from what is needless worrying (at least in my case).My thoughts are with you.
Kara
Posted by SLS on February 15, 2005, at 10:50:30
In reply to Re: SJW ok for severe depression? » KaraS, posted by Larry Hoover on February 14, 2005, at 22:21:36
> My arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery.
Wishing you nothing but the best.
- Scott
Posted by Larry Hoover on March 2, 2005, at 16:43:12
In reply to Re: SJW ok for severe depression? » Larry Hoover, posted by KaraS on February 14, 2005, at 23:49:50
>
> > I'm currently taking SJW and a similar dose of a tricyclic (trimipramine). I wouldn't worry about it at all.
>
> Thanks. You must have just started the SJW again. What brand are you taking and what dosage? I'm thinking of trying the HBC Protocols brand. Do you think that if one goes past the 900 mg. amount (or esp. if they take as much as 1800 mg.) that they'd need to watch their tyramine intake?I'm using Organika brand, 900 mg/day. It's actually not one of those kick-a$$ brands with hyperforin potency. Mild, gentle.
I've no reason to think that tyramine is an issue with any dose of SJW.
Did you know that an experimental protocol with SJW employed doses of 22,000 mg/day? That's not a typo. That was an AIDS trial, to determine antiviral activity (SJW does have antiviral effects in vitro). Turns out that SJW induces enzyme 3A4, which inactivated the major anti-HIV drugs, and made the SJW trial a failure. But the thing is, even that major dose was not associated with intolerable side effects.
> > My arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery. Nerve damage flaring up. I had a bad feeling about this the moment it happened. Some intuition is true.
> >
> > Lar
>
>
> I was afraid that might be the problem. I'm so sorry to hear that. Hopefully the surgery will correct the problem. Intuition is often correct. Yours certainly was. The trouble is determining what is intuition from what is needless worrying (at least in my case).
>
> My thoughts are with you.
>
> KaraThanks.
Lar
Posted by Larry Hoover on March 2, 2005, at 16:43:43
In reply to Re: SJW ok for severe depression? » Larry Hoover, posted by SLS on February 15, 2005, at 10:50:30
> > My arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery.
>
> Wishing you nothing but the best.
>
>
> - ScottThank you, sir.
Lar
Posted by KaraS on March 2, 2005, at 22:12:32
In reply to Re: SJW ok for severe depression? » KaraS, posted by Larry Hoover on March 2, 2005, at 16:43:12
> >
> > > I'm currently taking SJW and a similar dose of a tricyclic (trimipramine). I wouldn't worry about it at all.
> >
> > Thanks. You must have just started the SJW again. What brand are you taking and what dosage? I'm thinking of trying the HBC Protocols brand. Do you think that if one goes past the 900 mg. amount (or esp. if they take as much as 1800 mg.) that they'd need to watch their tyramine intake?
>
> I'm using Organika brand, 900 mg/day. It's actually not one of those kick-a$$ brands with hyperforin potency. Mild, gentle.
>
> I've no reason to think that tyramine is an issue with any dose of SJW.
>
> Did you know that an experimental protocol with SJW employed doses of 22,000 mg/day? That's not a typo. That was an AIDS trial, to determine antiviral activity (SJW does have antiviral effects in vitro). Turns out that SJW induces enzyme 3A4, which inactivated the major anti-HIV drugs, and made the SJW trial a failure. But the thing is, even that major dose was not associated with intolerable side effects.
>
> > > My arm is why I haven't been posting. It's really gone bad. I'm back on Percocet. I'm waiting for surgery. Nerve damage flaring up. I had a bad feeling about this the moment it happened. Some intuition is true.
> > >
> > > Lar
> >
> >
> > I was afraid that might be the problem. I'm so sorry to hear that. Hopefully the surgery will correct the problem. Intuition is often correct. Yours certainly was. The trouble is determining what is intuition from what is needless worrying (at least in my case).
> >
> > My thoughts are with you.
> >
> > Kara
>
> Thanks.
>
> Lar
>Thanks for the response. Good to know that you can safely take such large doses. Hope you're feeling better!
K
This is the end of the thread.
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