Posted by blueberry on November 18, 2006, at 8:39:44 [reposted on November 18, 2006, at 17:18:28 | original URL]
In reply to st johns wort safe with lamictal???!!!, posted by rovers95 on November 18, 2006, at 3:40:40
> hi, im up to 50mg lamictal now and doing OK!! Will the st johns wort have any adverse effect on lamictal effectiveness / levels??? this has kinda helped me in the past and i would like it to work for me again!!!
>
> markLast year I took 600mg SJW along with 10mg prozac 5mg zyprexa. It was safe at that dose and pretty effective with many benefits. I ran into trouble at 900mg where I felt something was overloaded and I got a tad manic.
When combining herbs and meds you just have to go slow and low. You never know what side effects or weird things might happen. For example, start SJW at 150mg for a few days and move up by 150mg every few days. Shoot for a target of 600mg and stay there for a few weeks to stabilize before even thinking of doing anything else with it.
SJW mostly decreases blood levels of drugs, but in some cases increases. Zyprexa levels are increased. The only true accurate way to know what is going on is to first stabilize at whatever doses you are comfortable with, and then have your doctor draw blood and have a lab measure the lamictal levels. After a few weeks, do it again to see how the levels have changed, if at all.
SJW changes drug levels by several mechanisms. The most common is by speeding up the liver enzymes CYP3A4 and CYP2C9. But it also has unknown actions at glycoprotein.
Go to pubmed.com and do some research on lamictal to see what liver enzymes break it down. If it is one of the 2 listed above, then you'll have good info to work with. If it is broken down by different enzymes than those 2 then interactions will be much less. You could do any number of google searches on lamictal to find out this info as well.
Lamictal does have some unknown reuptake inhibition characteristics which could theoretically lead to serotonin syndrome (dangerous). Do some research on that too so you know what to look for.
Overall it sounds fairly safe to me if approached with respect.
poster:blueberry
thread:704970
URL: http://www.dr-bob.org/babble/alter/20061118/msgs/704971.html