Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jkl77 on January 8, 2011, at 10:52:34
I am eating st john´s wort, 1800 mg/day. Now I want to start on Nefazodone instead. I read this:
"Nefazodone is metabolized by CYP 3A4."
"St john´s wort increases the amount of metabolizing enzymes, for example CYP3A4".Does that mean that there is an interaction between the two and that Nefazodone will not be as effective as it should be? If so, how long must I wait after discontinuing st john´s wort until I can start taking nefazodone with full effect?
Posted by Phillipa on January 8, 2011, at 12:51:02
In reply to st john´s wort/nefazodone interaction, posted by jkl77 on January 8, 2011, at 10:52:34
You must live in the USA as in Europe and Canada the drug is banned for liver damage. I'm not sure what class of med serzone is but it acted like an antihistamine in me didn't continue long a few days or so. I heard St John's wort was pretty good for mild to moderate depression. So assuming it doesn't work for you? What made you decide on Serzone? Phillipa
Posted by jkl77 on January 8, 2011, at 16:36:00
In reply to Re: st john´s wort/nefazodone interaction » jkl77, posted by Phillipa on January 8, 2011, at 12:51:02
I live in Sweden but I got it on license. I think it´s like an SSRI but without the sexual side effects. So I want to test it.
Posted by MissThang on January 9, 2011, at 2:20:55
In reply to st john´s wort/nefazodone interaction, posted by jkl77 on January 8, 2011, at 10:52:34
St. John's Wort and 5htp complement each other well. 5htp is a natural serotonin enhancer and is less likely than regular ssri's to have sexual side effects. I've used them together before and had great results, though in my case, they pooped out. But they may work great for you on a longer term basis. I'd definitely try it before I risked my liver on serzone.
Posted by bleauberry on January 10, 2011, at 12:52:03
In reply to st john´s wort/nefazodone interaction, posted by jkl77 on January 8, 2011, at 10:52:34
I would venture a guess you will be in for a wild unpleasant ride if you stop 1800mg st johns wort rapidly.
Everyone is different, so who knows. I was on it about 3 months at 600mg to 900mg. I weaned down to zero rapidly, about a week. No problem until about 3 days later when I had serious panic attacks and other withdrawal complications. It landed me in the emergency room because it was so profound and I had no idea what was happening to me. It was withdrawals. A single pill of Xanax ended it in about 20 minutes. And then about a month of as-needed xanax until the SJW was completely gone. It is a plant, but plants are medicine, and this one has some potency. You might consider being cautious and slow with any changes.
The interaction between SJW and serzone has to do with how fast they are cleared by the liver from the body. You may have to adjust doses.
Other interactions, if any, no one knows. I guess serotonin syndrome is always a potential risk, so it's worth knowing the symptoms to look for and the pattern in which they present themselves.
If SJW was working good and then seemed to poop out some, a trick many others have discovered is that the way to revive it is to lower the dose. Yep, that's right, lower the dose. Not raise it. You might consider seeing what happens along the journey during a slow methodical weaning.
Another trick is...switch brands. It is staggering how people respond to one brand very well and to another very poorly. The particular brand is unpredictable. Sometimes it's the cheap stuff, sometimes the best stuff. Longtime SJW fans claim that if you have not tried several different brands, you haven't given SJW a fair trial.
Posted by jkl77 on January 10, 2011, at 14:42:57
In reply to Re: st john´s wort/nefazodone interaction, posted by bleauberry on January 10, 2011, at 12:52:03
I changed my mind and started on paroxetine instead. I just quit from 1800 mg of st johns wort to zero. And started on paroxetine 20 mg two days after. No problems yet...
Both st johns wort and paroxetine boosts serotonine levels. So I thought it was I good idea just to change.
Like if you change from one SSRI to another you can just change them from one day to another.
Posted by MissThang on January 10, 2011, at 15:07:44
In reply to Re: st john´s wort/nefazodone interaction, posted by jkl77 on January 10, 2011, at 14:42:57
My understanding of St. John's Wort's action is that it acts as not only a serotonin booster but also as an MAOI, so I'm still a little concerned that you stopped cold turkey.
Posted by jkl77 on January 11, 2011, at 20:19:17
In reply to Re: st john´s wort/nefazodone interaction, posted by bleauberry on January 10, 2011, at 12:52:03
You were absolutely right. :-( I feel horrible now, vomiting 20 times last 10 hours. Do you think diazepam works as well as xanax for withdrawals??
> I would venture a guess you will be in for a wild unpleasant ride if you stop 1800mg st johns wort rapidly.
>
> Everyone is different, so who knows. I was on it about 3 months at 600mg to 900mg. I weaned down to zero rapidly, about a week. No problem until about 3 days later when I had serious panic attacks and other withdrawal complications. It landed me in the emergency room because it was so profound and I had no idea what was happening to me. It was withdrawals. A single pill of Xanax ended it in about 20 minutes. And then about a month of as-needed xanax until the SJW was completely gone. It is a plant, but plants are medicine, and this one has some potency. You might consider being cautious and slow with any changes.
>
> The interaction between SJW and serzone has to do with how fast they are cleared by the liver from the body. You may have to adjust doses.
>
> Other interactions, if any, no one knows. I guess serotonin syndrome is always a potential risk, so it's worth knowing the symptoms to look for and the pattern in which they present themselves.
>
> If SJW was working good and then seemed to poop out some, a trick many others have discovered is that the way to revive it is to lower the dose. Yep, that's right, lower the dose. Not raise it. You might consider seeing what happens along the journey during a slow methodical weaning.
>
> Another trick is...switch brands. It is staggering how people respond to one brand very well and to another very poorly. The particular brand is unpredictable. Sometimes it's the cheap stuff, sometimes the best stuff. Longtime SJW fans claim that if you have not tried several different brands, you haven't given SJW a fair trial.
Posted by Phillipa on January 11, 2011, at 21:18:28
In reply to Re: st john´s wort/nefazodone interaction, posted by jkl77 on January 11, 2011, at 20:19:17
I think you should call a doc ASAP you will be dehydrated. Seriously. Phillipa
Posted by jkl77 on January 11, 2011, at 21:43:22
In reply to Re: st john´s wort/nefazodone interaction » jkl77, posted by Phillipa on January 11, 2011, at 21:18:28
But I feel a little better now last two hours and can drink again without vomiting. I also took 1500 mg of st john´s wort now to reduce withdrawal syndroms. But Xanax will not help for vomiting, will it?
Posted by Phillipa on January 11, 2011, at 23:45:43
In reply to Re: st john´s wort/nefazodone interaction, posted by jkl77 on January 11, 2011, at 21:43:22
So if no vomiting are you able to drink and eat? Phillipa
Posted by MissThang on January 12, 2011, at 3:10:50
In reply to Re: st john´s wort/nefazodone interaction » jkl77, posted by Phillipa on January 11, 2011, at 23:45:43
Thorazine will help with vomiting if you have some -- it will likely help some with withdrawels as well.
This is the end of the thread.
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