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Re: selegiline and hypericum

Posted by Sunnely on August 27, 2000, at 23:24:02

In reply to selegiline and hypericum, posted by Jef Kazak on August 24, 2000, at 8:54:18

> Can selegiline be taken together with hypericum (St. John's Wort)? I've only just started taking selegiline at very low doses, 2.5 mg per day, but before I liked the effect of hypericum at low doses too (300mg per day, taken before bedtime). Since I've read that hypericum acts like a SSRI or a IMAO-A at the recommendable dose of 900mg per day, I was wondering it it's safe to take the two together at low doses.

Hi Jef,

I have not encountered in the literature report of bad interaction between St. John's wort (SJW) and selegiline (Eldepryl). Theoretically, it is possible. SJW is purported to have monoamine oxidase inhibiting (MAOI) action. Combining medications with MAOI action (? e.g., SJW), even selective MOAI B like selegiline, can be potentially dangerous since they could lead to serotnin syndrome. Cases of serotonin syndrome from combination of selegiline and antidepressants have been reported. Also, cases of serotonin syndrome from combination of SJW and SSRIs have been reported.

Incidentally, in one recent study, the use of selegiline transdermal system (STS) or patch form, was found safe and effective treatment for patients with major depressive disorder and may have a rapid onset of action.

References:

1. Selegiline and Serotonin Syndrome. In: Psychiatry Drug Alerts, July 1997.

2. Natural Medicines: Comprehensive Database, 2000. Published by Therapeutic Research Faculty, Stockton, CA.

3. New data presented on lithium, transdermal selegiline. In: Psychopharmacology Update, August 2000.


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