Posted by bleauberry on August 27, 2010, at 17:03:02
In reply to St Johns Wort Combined with SSRI's, posted by Phillipa on August 27, 2010, at 13:41:30
I combined 600mg SJW with 20mg prozac and 5mg zyprexa for about 2 months. After 2 weeks it was actually surprising me in terms of renewed interest, motivation, and social comfort. I wasn't very depressed prior since prozac and zyprexa did a decent job on that, but I had that typical ssri flatness. SJW brought some life into it and was strongly anti-anhedonia.
The only drawback with SJW is the way it affects the metabolism of other substances. Most of them it will decrease their blood levels, thus difficulty in cancer patients, implant patients, HIV, etc, and such unless blood levels are monitored and adjusted. Some meds will actually see an increase of blood levels, as I experienced with zyprexa. Toward the end of that 2 months I was getting mild but bizarre movement disorders that were clearly antipsychotic in nature....twisting tongue, tics, twitches, etc. I didn't know at the time, but SJW was gradually increasing the blood level of zyprexa by about 300%.
In terms of serotonin syndrome, I dunno, anything is possible, but with a careful approach I doubt it.
I am a fan of SJW, but it has to be kept in perspective...the dose can vary anywhere from 75mg a day to 1800mg a day, it should be a clinical brand such as Kira or Perika with 600mg to 900mg being most common; mileage varies; no guarantees. It has its place. Honestly I think if most people started with it, as in Germany, many would never need a pharmaceutical drug.
It has pros and cons. My doctor had no problem with it.
IMO it is safe to combine with ssris but must be done so in a responsible manner. In other words, the first dose is not 300mg, 600mg or 900mg. It is a quarter of a dose, 75mg. For a few days. And then increase it as needed every 4 days or so in 75mg steps. That is a responsible way to combine it with an ssri as I see it.
poster:bleauberry
thread:960149
URL: http://www.dr-bob.org/babble/20100821/msgs/960177.html