Experiences - St Johns Wort. Effects, Use, Side-effects and Precautions

[0utrider]

Hi

SWIM thinks that most SSRI's are too strong and dangerous to be messed with and also seems to be sensitive to these infamous "2 weeks to 2 months" till it (depending on the type & person) starts to work.

He thinks about giving St Johns-Wort a try, since its supposed to be relatively weak (if not almost not working, according to some studies) and the Noradrenaline effect seems to be quite nice, supposedly (in theory) giving a little energy, apart from the serotonine.

It appartenly works on the Neurotransmitter Serotonine and Noradrenaline as an RI, and also the concentration of GABA, Dopamine & L-Glutamate is supposed to rise (which is no other SSRI / similar able to do right now) and thus reducing the number of noradrenogenic receptors (adrenaline) and raising the amount of 5-ht2 receptors (serotonine). this is just theory, and reality it seems to be pretty low.

So i have a few questions.
First, any experiences?
Second, whats a recommended dosage (and what kind of St Johns, extract etc ?!)
Third: What drugs does SWIM have to be careful with, he knows about the SSRI stuff (i.e. MDMA, BZP, most amphetamines, etc), but what other drugs to be careful with. he also read (in addition) about interfearance with Cytochrom P450 and CYP 3A4 and would like to know what the results of these in taking drugs are and regarding hormones (natural and taken, especially DHEA and, even though not for him, just for the sake of it, the anti-baby-pill)
and Fourth: Other positive and negative side effetcs, for example effects on the liver (which are supposed to be "not-good", but are they "normal" for ADs or too agressive for normal-healthy people) and apparent anti-biotic effects etc
Last: is the photosensitivity really a big issue? (of course depending on the individual, but is it likely and strong or rather a seldom problem?)

Thanks for the infos. for further infos SWIY can read http://en.wikipedia.org/wiki/St_John%27s_wort but i also wanna know "firt hand" infos, since wikipedia is often not too reliable and one wants to be a little more careful with his health.

[0utrider]

Ok so i did some more reearch and it seems to be actually working and also the effects can actually be different/better (i.e. a little more energetic) than some other AD, because of the different methods of actions.

The Photosensitivity is apparently rather rare and can be noticed that you get sunburns in situations where you'd usually never get em.

Other than that its similar to other ADs, especiialy SSRIs and NARIs and thus in moderation used, slowly started, not a threat for a healthy person.

also

St John's wort may interact with birth control pills and may reduce the effectiveness of oral contraceptives. However, while breakthrough bleeding was observed to occur in the Swedish MPA study (the sample size of 8 women was small enough that the effect could not be differentiated from common breakthrough bleeding), no cases of pregnancy due to contraceptive/St John's wort interactions have been found in the literature despite over 20 years of widespread prescription in Germany

i think this might answer my question about the DHEA, but i'd be glad for other answers

but one more think stays unclear for me. these 2 Enzymes seem to be involved: http://en.wikipedia.org/wiki/CYP3A4#CYP3A4_ligands
http://en.wikipedia.org/wiki/CYP2C9#CYP2C9_Ligands

But practically, what does this mean in conclusion for SWIM who'd want to use drugs?!

[0utrider]

RESULTS OF CONSUMERLAB.COM TESTING OF ST. JOHN'S WORT SUPPLEMENTS


Amazon St. John's Wort 300mg (300 mg herb per capsule, 1 -2 per day)
Ingredients Mfd. by Amazon Nutraceuticals NOT
APPROVED Contained claimed amount per pill but suggested daily dose was too low


Eckerd® St. John's Wort [Standardized Herbal extract, 150mg (150 mg extract per capsule, 6 per day)
Ingredients Dist. by Eckerd Drug Company APPROVED


Flora St. John's Wort Extract (90 capsules/ 430mg) Wild-grown Full-Spectrum Extract, Sun-infused in Extra-Virgin Olive Oil (430 mg oil extract per capsule, 3-5 per day)
Ingredients Dist. by Flora Inc. NOT
APPROVED
Label did not state part of herb used. Not tested. N/A
N/A

GNC Herbal Plus® Standardized St.John's Wort (Minimum 0.3% Hypericin (0.9mg)) (300 mg extract per tablet, 1-3 per day)
Ingredients Dist. by General Nutrition Corp. NOT
APPROVED

Exceeded limit for cadmium

KAL® Beyond St. John's Wort™ [Full-Spectrum Formula Dietary Supplement] (150 mg extract per tablet, 2 per day)
Ingredients Mfd. by Nutraceutical Corp for Makers of KAL, Inc. NOT
APPROVED
Less than 75% hypericin claim and less than 40% of hyperforin claim
Exceeded limit for cadmium

Kira® St. John's Wort Dietary supplement 45 tablets, Standardized and Tested — Lichtwer Pharma Exclusive L I 160™ Formula (300 mg extract per tablet, 3 per day)
Ingredients
Dist. by ABKit Inc. APPROVED


LifeWise® Naturals Guaranteed Potency St. John's Wort Extract (300 mg extract per capsule, 3 per day)
Ingredients Mfd. by LifeWise Naturals, Inc. APPROVED


Nature's Resource® Herbal Supplement St. John's Wort Standardized Extract (150 mg extract per capsule, 6 per day)*
Ingredients Dist. by Nature's Resource Products APPROVED


Nature's Resource® Herbal Supplement St. John's Wort Standardized Extract (300 mg extract per capsule, 3 per day)*
Ingredients Dist. by Nature's Resource Products APPROVED


Nature's Sunshine® Concentrated St. John's Wort (300 mg extract per capsule, 3 per day)
Ingredients Mfd. by Nature's Sunshine Products Inc. NOT
APPROVED
Label did not state part of herb used. Not tested. N/A
N/A

Nutrilite® St. John's Wort with Lemon Balm (300 mg extract per capsule, 3 per day)*
Ingredients Dist. by Access Business Group International LLC APPROVED


Puritan's Pride® Inspired by Nature™ St. John's Wort Standardized Extract (300 mg extract per capsule, 3 per day)*
Ingredients Mfd. by Puritan's Pride Inc. APPROVED


Solgar St. John's Wort (Standardized & Full Potency)™ Herb Extract (Hypericum perforatum) [Standardized extract including 0.5mg (0.3%) hypericin with raw St. John's Wort herb powder. (175 mg extract & 300 mg herb per capsule, 1-3 per day)
Ingredients Mfd. by Solgar Vitamin and Herb NOT
APPROVED
Exceeded limits for lead and cadmium

Vitamin World® Select Herbals: Standardized Extract St. John's Wort [Standardized to contain 0.3%Hypericin] (150 mg extract per capsule, 3 per day)*
Ingredients Mfd. by Vitamin World Inc. APPROVED


VitaSmart® St. John's Wort Standardized Extract (300 mg extract per caplet, 3 per day)
Ingredients Dist. by Kmart Corporation APPROVED


*Tested through CL's Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review.
N/A — Not applicable. Product not tested because it failed to meet FDA labeling requirements.

Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time. So be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.


ConsumerTips™ for Buying and Using:
When buying a St. John's wort supplement, be sure to look at the label to find out if the product is made from an extract or whole herb (i.e., dried, powdered herb). Most of the St. John's wort preparations evaluated and found effective in clinical trials were extracts standardized to contain approximately 0.3% hypericin, and taken in a dose of 300 mg three times daily. Other products that have shown benefits were standardized to 1 - 3% hyperforin, again taken at 300 mg three times a day. Whole herb is usually taken at a dose of 2 to 4 grams per day and should contain 0.1% to 0.15% hypericin. One product that failed the review was an herb powder that suggested 1 to 2 capsules daily (300 to 600 mg of whole herb), while 7 to 13 capsules would actually be needed to provide 2 to 4 grams.

Labels on St. John's wort products should also indicate the parts of the plant used. These should be the flowers and leaves — also referred to as "aerial portions" (which may also include stems) — but not the roots.

As with conventional antidepressants, it appears that St. John's wort takes several weeks to achieve full effects.

Cautions and Concerns:
St. John's wort is generally safe when taken in appropriate amounts, seldom causing more than occasional mild digestive distress. However, like all antidepressants, St. John's wort can cause manic episodes in people with bipolar disorder. Use of St. John's wort has also been linked to hair loss in one report (as has use of conventional antidepressants).

At high doses St. John's wort increases sensitivity to ultraviolet light (the part of sunlight that causes sunburn). Although normal doses of St. John's wort are not likely to cause this problem, some people could be unusually sensitive. Furthermore, there are reports of unexpected sunburn in people taking St. John's wort at normal doses and then getting medical ultraviolet treatment. For this reason, it is not recommended to get a high level of sun or ultraviolet exposure while using St. John's wort. Amplification of this effect by drugs (such as sulfa antibiotics) that can increase sun sensitivity could be a possibility as well.

Finally, there is a little evidence that excessive doses of St. John's wort might slightly impair mental function, and in one report the herb appeared to cause severe worsening of symptoms of Alzheimer's disease.

The most significant risk with St. John's wort involves drug interactions. It appears that St. John's wort may reduce blood levels of many medications, thus reducing their effectiveness. This interaction might occur with as many as half of all the drugs in use today. Some of the strongest and most worrisome evidence involves the following medications:

Drugs Which May Have Reduced Effectiveness When Used with St. John's Wort
Drug: Possible harmful effect of combination with St. John's wort:
Cyclosporine or tacrolimus, used to suppress transplant rejection Transplant rejection
Oral Contraceptives Unintended pregnancy
Protease inhibitors and non-nucleoside reverse transcriptase inhibitors used for HIV infection Worsening of HIV symptoms
Digoxin, a treatment for various forms of heart disease Increased heart disease symptoms
Statin drugs, taken to improve cholesterol levels Higher levels of cholesterol
Warfarin (coumadin), a blood thinner used to prevent blood clots Failure of protection against blood clots
Various cancer chemotherapy drugs Loss of efficacy against cancer
Anti-psychotic drugs in the olanzapine and clozapine category Increased symptoms of psychosis
Omeprazole (Prilosec) and related drugs Increased ulcer or esophageal reflux symptoms

Note that there is a kind of reverse risk with these interactions to consider too. If you are taking St. John's wort, and your physician adjusts your medication levels to get the proper blood levels, if you then stop taking the herb, medication levels will suddenly rise. This could cause toxic side effects.

Besides reducing blood levels of medications, St. John's wort can cause other problems if taken in combination with certain drugs. Some of the most important of these miscellaneous interactions include:

Other Drugs Impacted by St. John's Wort
Drug: Possible harmful effect of combination with St. John's wort:
Conventional antidepressants, especially those in the SSRI family (such as Celexa, Prozac and Zoloft), but also possibly other antidepressants, as well as anti-migraine drugs and the painkiller tramadol Excessive serotonin levels, leading to "serotonin syndrome," a condition that includes one or more of the following symptoms: nausea, anxiety, mental confusion, fever, tremor, seizures, altered heart rate, unstable blood pressure, and even death.
Anesthetics Delayed emergence from anesthesia after surgery
Drugs that can cause sun sensitivity (especially the anti-inflammatory medication piroxicam and sulfa antibiotics) Increased sun sensitivity
MAO inhibitors, stimulant drugs, and the substance tyramine (found in aged cheese, wine, fermented soy products, cured meats, and beer) MAOI interaction, consisting of rapid heart rate, high blood pressure and sometimes delirium

NOTE: While the above discussion may make it seem that St. John's wort is an unusually dangerous herb, it is probably more accurate to say that it is an especially well studied herb, and its risks are better known. For example, grapefruit juice causes many of the same drug interactions described above, and it is not ordinarily considered a dangerous substance!

Because of all these actions and interactions, individuals should discuss using St. John's wort with their physician before taking it.

The safety of St. John's wort hasn't been well evaluated in children or during pregnancy or breast-feeding. Therefore, it isn't recommended for women who may become pregnant.

if found some more info.. i

[kaczynski]

As far as personal experiences, SWIM has been taking twice the recommended dose for a few weeks now and has never noticed any specific effects. However, SWIM is also on a self-prescribed, and arguably unhealthy, vitamin regimen and wouldn't be able to distinguish which effects were caused by which supplement.

[3333]

Swim has heard a lot of people not benefiting from it. Swim has never tried it, but from what swim has heard, it it much weaker than ssri's and it is very unlikely to work on people with severe depression.

[0utrider]

swim feels like its helping him w/d of opiates and in general stabilizing his mood but is not certain about this. but he made sure he got enough of the ingredient since many products dont contain enough of it.. one has to be aware of that

[0utrider]

http://www.drugs-forum.co.uk/forum/s...ght=johns+wort

[wespawloski]

"SWIM thinks that most SSRI's are too strong and dangerous to be messed with"

LOL strong like an ant, it sure can move that pebble