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32 years
Dr zakia: is st john wort supplement healthy ? And is there any side effect and interaction with anti deporessant meds?
Sep 10, 2014
2nd opinion

Dr. Zakia Dimassi Pediatrics
St-John's-wort, genus name Hypericum perforatum, is recommended traditionally to ease depression, and other medical conditions. Some studies have demonstrated to be as effective as antidepressants (tricyclic antidepressants TCAs and selective serotonin reuptake inhibitors SSRIs) in the management of mild to moderate depressive symptoms. How this herbal extract works remains unclear. Several potentially harmful interactions between St. John’s wart and a number of prescription drugs have been cited, including:

1- Antidepressants:
• Paroxetine ---- Lethargy/incoherence
• Trazodone ---- Mild serotonin syndrome
• Sertraline ---- Mild serotonin syndrome
• Nefazodone ---- Mild serotonin syndrome
2- Bronchodilator (dilates airways in cases of asthma)
• Theophylline ---- Decreased bioavailability
3- Blood thinners
• Warfarin ---- bleeding
• Phenprocoumon ---- Decreased bioavailability
4- Antiviral

• Indinavir (antiviral, HIV treatment) ---- decreased bioavailability
5- Cardiac medications
• Digoxin (for heart disease) ---- decreased bioavailability
6- Combined oral contraceptive (ethinyloestradiol) and desogestrel ---- Breakthrough bleeding

St-John's-wort may mildly mimic monoamine oxidase inhibitor (MAOI) drugs and should not be used when taking antidepressent medication such as phenelzine. It could aslo duplicate the effect of SSRIs such as Prozac and Zoloft. As such, Saint-John's-wort could precipitate headache, sweating, dizziness, and agitation when taken in combination with SSRIs. It can also interfere with certain seizure medications as well as lithium. Saint-John's-wort may intensify the effects of sedatives and diabetes medications.
Theoretically, St-John's-wort may aggravate sun damage if taken concurrently with photosensitizing drugs (drugs that can worsen or cause skin damage upon exposure to sunlight) such as tretinoin (Retin-A). It can also alter the activity of a number of used in the treatment of high cholesterol and high blood pressure.
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