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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by med_empowered on October 1, 2005, at 11:44:41
hey everyone. I've been on a A LOT of meds with limited success...anyway, I'm dealing with a problem variably described as "Mood Disorder NOS" or bipolar disorder NOS (somehow, with all the diangoses in the DSM, I still end up in the "what the hell is wrong with you?" pile). So, since I've had so many problems with conventional meds--weight gain/loss, withdrawal, hairloss, cognitive blunting, insomnia/hypersomnia, etc. etc.--I've decided to try "alternative" stuff. I visited a friend of a friend--she does herbal medicine and nutrition stuff, and makes referalls to "alternative" shrinks and what not-- and she recommended *HIGH* dose (max: 5,400mgs) saint john's wort. I was taken aback, so I did some research on it before I dove in; turns out, there have been some studies using high doses that compared favorably to antidepressants, even the tricyclics (this is important b/c tricyclics have an "edge" in more serious, endogenous forms of depression and anxiety compared to the SSRIs, and that's the form of depression..or whatever...that I deal with). So, I've been doing this for a week, maybe 2, and...I feel really, really good. Not manic--I sleep better, and my thoughts are calm but coherent--and not "wired"; just...better. My anxiety is much improved, the depression less so (but I'm able to leave the house and do stuff, which is helping me work on the depression at a social level). I haven't really noted any side effects...I wear an SPF-15 anyway, so I haven't had any photosensitivity issues. Does anyone have experience with this kind of dosing, or any advice, comments, suggestions? I'd really appreciate any and all input I can get.
Posted by Declan on October 1, 2005, at 14:50:58
In reply to *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 1, 2005, at 11:44:41
Hi Med
I stopped taking St John's Wort because of photosensitivity (Australian sun). Linkadge, I think, mentioned that it was available with the hypericin taken out, that causing the problem. It's the hyperforin that's therapeutic?
Declan
Posted by JLx on October 1, 2005, at 16:41:56
In reply to *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 1, 2005, at 11:44:41
> hey everyone. I've been on a A LOT of meds with limited success...anyway, I'm dealing with a problem variably described as "Mood Disorder NOS" or bipolar disorder NOS (somehow, with all the diangoses in the DSM, I still end up in the "what the hell is wrong with you?" pile). So, since I've had so many problems with conventional meds--weight gain/loss, withdrawal, hairloss, cognitive blunting, insomnia/hypersomnia, etc. etc.--I've decided to try "alternative" stuff. I visited a friend of a friend--she does herbal medicine and nutrition stuff, and makes referalls to "alternative" shrinks and what not-- and she recommended *HIGH* dose (max: 5,400mgs) saint john's wort. I was taken aback, so I did some research on it before I dove in; turns out, there have been some studies using high doses that compared favorably to antidepressants, even the tricyclics (this is important b/c tricyclics have an "edge" in more serious, endogenous forms of depression and anxiety compared to the SSRIs, and that's the form of depression..or whatever...that I deal with). So, I've been doing this for a week, maybe 2, and...I feel really, really good. Not manic--I sleep better, and my thoughts are calm but coherent--and not "wired"; just...better. My anxiety is much improved, the depression less so (but I'm able to leave the house and do stuff, which is helping me work on the depression at a social level). I haven't really noted any side effects...I wear an SPF-15 anyway, so I haven't had any photosensitivity issues. Does anyone have experience with this kind of dosing, or any advice, comments, suggestions? I'd really appreciate any and all input I can get.
Standard dose is 900 mg, twice that is considered a high dose. You're taking 6 times a standard dose. Were you told a rationale for this particular number?
I think I might be concerned about effects to the liver and take milk thistle to help support it.
What brand SJW are you taking? I found this comment interesting from a SJW discussion site, where Perika and Kira are the preferred brands apparently:
"Perika and Kira are produced by different pharmaceutical companies in Germany. According to an article written by Wurglics et al for the Journal of American Pharmacology (cited elsewhere on Kelly's site) Perika has higher hyperforin content and a comparably low hypericin content. Kira has hyperforin/hypericin contents that are more balanced. I believe some people like Perika more because the higher hyperforin content seems to provide a needed boost for their personality type. I believe some people don't have a good reaction to the high hyperforin content, which seems to make them feel like they are more moody than before. When Perika works for people, they really rave about it, but Kira seems to have fewer complaints associated with it." http://www.sjwinfo.org/
I tried SJW some years back. Or maybe I didn't given all the publicity there has been about labs testing various brands and finding great disparities in actual content.
JL
Posted by ed_uk on October 2, 2005, at 8:53:46
In reply to *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 1, 2005, at 11:44:41
Hey Med,
That's great that it's helping! Keep us updated :-)
~Ed
Posted by med_empowered on October 2, 2005, at 10:48:53
In reply to Re: *HIGH* Dose St.John's Wort...questions » med_empowered, posted by ed_uk on October 2, 2005, at 8:53:46
hey everyone! Thanks for the input. OK, I think the reasoning behind high-dosing it is as follows: 1) st.john's wort is effective as an antidepressant, but this particular person told me she thinks the usual dose (900mgs) fails a lot of people--just like a lot of people will fail on 75mgs Effexor, but do great on 375mgs. 2) She thinks its possible to "load" st.john's wort; apparently, the active chemicals cross the blood-brain barrier; they are eliminated relatively quickly from most of the body, but tend to stick around the in brain for a while (this is also seen with some other drugs, like haloperidol). The theory is that the part of the delay from consumption to antidepressant effect is accumulation of an effective concentration in the brain...so, if you "load," you get there faster. Also, I think she plans to cut the dose once this "loading" has been completed (I guess this is kind of like the "rapid neuroleptization" that used to be standard practice for schizophrenia). and 3) There are my personal factors. I've taken all kinds of meds--mood-stabilizers (anticonvulsant type), neuroleptics, benzos, stimulants, antidepressants, etc....all helped, but all also had side effects; sometimes, I did best on polypharmacy that combined seemingly contradictory medications (ex: adderall+klonopin, that kind of thing). SHe thinks--and I think this is reasonably well-supported by research--that st. john's wort is a pretty powerful broad-spectrum antidepressant; the trick is to get up to an effective dose while avoiding side effects (which, luckily, dont seem to pop up all too often). It seems to help a bit with motivation, while also calming anxiety and it calms depression without inducing apathy (big problem for me with SSRIs); since its a plant, and there are bunches of different chemicals in it, I suppose the theory is that taking st. john's wort is kind of like polypharmacy...in one pill/plant. She also claims that st. john's wort doesn't seem to induce mania/mixed episodes/psychosis/suicidality; this is true, as far as I can tell...hypothetically, there should be problems if you mix it with a conventional med, but on its own, there aren't many reports of ill-effects, physical or psychiatric. Thanks again for all the input, and I'd appreciate other recommendations on alternative stuff to try...I'm considering valerian for daytime anxiety, but I'm worried about sedation and/or worsening of pre-existing depression.
Posted by JLx on October 2, 2005, at 12:04:43
In reply to Re: *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 2, 2005, at 10:48:53
Posted by Optimist on October 4, 2005, at 8:59:32
In reply to *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 1, 2005, at 11:44:41
I tried 2700mg a day for awhile a couple years ago. The AD effects weren't phenomenal but they did help to some degree. It was almost devoid of side effects. Some dry mouth I think, but sun sensitivity wasn't a problem. I went to the tanning bed regularily and didn't notice much of a change. I was taking "Natures Way" brand, here in Canada.
Brian
> hey everyone. I've been on a A LOT of meds with limited success...anyway, I'm dealing with a problem variably described as "Mood Disorder NOS" or bipolar disorder NOS (somehow, with all the diangoses in the DSM, I still end up in the "what the hell is wrong with you?" pile). So, since I've had so many problems with conventional meds--weight gain/loss, withdrawal, hairloss, cognitive blunting, insomnia/hypersomnia, etc. etc.--I've decided to try "alternative" stuff. I visited a friend of a friend--she does herbal medicine and nutrition stuff, and makes referalls to "alternative" shrinks and what not-- and she recommended *HIGH* dose (max: 5,400mgs) saint john's wort. I was taken aback, so I did some research on it before I dove in; turns out, there have been some studies using high doses that compared favorably to antidepressants, even the tricyclics (this is important b/c tricyclics have an "edge" in more serious, endogenous forms of depression and anxiety compared to the SSRIs, and that's the form of depression..or whatever...that I deal with). So, I've been doing this for a week, maybe 2, and...I feel really, really good. Not manic--I sleep better, and my thoughts are calm but coherent--and not "wired"; just...better. My anxiety is much improved, the depression less so (but I'm able to leave the house and do stuff, which is helping me work on the depression at a social level). I haven't really noted any side effects...I wear an SPF-15 anyway, so I haven't had any photosensitivity issues. Does anyone have experience with this kind of dosing, or any advice, comments, suggestions? I'd really appreciate any and all input I can get.
Posted by blueberry on October 4, 2005, at 19:38:09
In reply to *HIGH* Dose St.John's Wort...questions, posted by med_empowered on October 1, 2005, at 11:44:41
For the average Joe without any hint of bipolar characteristics, I think sjw is a fantastic herb. Based on my own experience though, it can indeed induce hypomania followed by a crash and rapid cycling.
I read somewhere that higher doses are actually counterproductive. Supposedly because the GABA reuptake inhibition part of it gets so strong that it over rides all the rest of it, shuts down dopamine release.
Poop out is real common with sjw. There is another site on the web devoted just to folks posting about their experiences with sjw, and poopout is all over the place.
I never felt better in my life than I did on sjw. It's just that it pooped out, made me more depressed than when I started, and higher doses made it even worse. Best dose for me was 900mg Kira brand. Went up as high as 1800mg.
Withdrawing from it was, I swear, exactly like withdrawing from a benzodiazapine. It was hard, it was awful. Again, I think it was the GABA reuptake inhibition that caused that. Or possibly the glutamate reuptake inhibition. Two weeks after I had finally weaned off of it, I had fierce anxiety which I had never had in my life before, and I had intense scary panic attacks that sent me to the hospital.
Sjw is awesome. But it can also be scary. It's just a plant, but it is very powerful in the brain.
This is the end of the thread.
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