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MAOI antiudepressants (including SJW)

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Locus said:

Actually SJW is an SSRI, and questionably has MAOI properties as well. Generally drug interactions with SJW are uncommon, and a lot of the info you posted above is questionable.

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St. John's wort is an SSRI? No it isn't, it likely blocks 5-HT1A receptors to some  extent but it isn't selective. Actually, it may not even block it, but I can look in to that too. But it isn't an SSRI.

As for interactions with medicines, it isn't the simple fact that mixing an MAOI with an SSRI can lead to serotonin syndrome ? it's the fact that SSRI's ALONE can lead to serotonin syndrome and using SJW willy nilly brings you one step closer. If, on top of this the patient has other undiagnosed conditions such as OCD, bi-polar disorder, tourette's  or schizophrenia which already have associated catecholamine elevations, then you can run in to problems. These aforementioned conditions may also mimic serotinin syndrome states. (which is dangerous in itself)

Also one of the reasons that SSRI's are given to young people is because young people tend to dabble in drugs

SJW is reasonably assumed to be contraindicated with any manic condition too, btw.

I've looked in to why it might be contraindicated with the Atkin's diet, and sure enough here it is:

Depression, among other non-cognitive symptoms, is common in patients with dementia. The effect of Hypericum perforatum (St. John's Wort) extract, with well-documented antidepressant activity, was tested on memory retrieval 24 h after training on a one-trial passive avoidance task in mice. Acute administration of Hypericum extract (4.0, 8.0, 12.0, and 25.0 mg/kg i.p.) before retrieval testing increased the step-down latency during the test session. The same doses of Hypericum extract, on the other hand, failed to reverse scopolamine-induced amnesia of a two-trial passive avoidance task. The involvement of serotonergic, adrenergic, and dopaminergic mechanisms in the facilitatory effect of Hypericum extract on retrieval memory was investigated. Pretreatment of the animals with serotonergic 5-HT1A receptor antagonist (-)-pindolol (0.3, 1.0, and 3.0 mg/kg), serotonergic 5-HT2A receptor blocker spiperone (0.01, 0.03, and 0.1 mg/kg), alpha adrenoceptor antagonist phentolamine (1, 5, and 10 mg/kg), beta receptor antagonist propranolol (5, 7.5, and 10 mg/kg), dopaminergic D1 receptor antagonist SCH 23390 (0.01, 0.05, and 0.1 mg/kg), and dopaminergic D2 receptor antagonist sulpiride (5, 7.5, and 10 mg/kg) revealed the involvement of adrenergic and serotonergic 5-HT1A receptors in the facilitatory effect of Hypericum extract on retrieval memory.

It's because of the fact that the Atkin's diet inherently increases dopamine and adrenal hormones, due to the fact that it lowers blood glucose levels, and St. John's wort also likely increases adrenal activity.

St John's wort-drug interactions
1.???????? TGA, TGA alert to doctors and pharmacists and complementary health practitioners. Important interactions between St John's wort (Hypericum perforatum) preparations and prescriptions medicines. 2000.
2.???????? Moschella, C. and B. Jaber, Interaction between cyclosporine and Hypericum perforatum (St. John's wort) after organ transplantation. American Journal of Kidney Diseases, 2001. 38(5): p. 1105-1107.
3.???????? Karliova, M., et al., Interaction of Hypericum perforatum (St John's wort) with cyclosporin A metabolism in a patient after liver transplantation. Journal of Hepatology, 2000. 33: p. 853-855.
4.???????? Mai, I., et al., Hazardous pharmacokinetic interaction of St John's wort (Hypericum perforatum) with the immunosuppressant cyclosporin. International Journal of Clinical Pharmacology and Therapeutics, 2000. 38(10): p. 500-502.
5.???????? Mandelbaum, A., et al., Unexpained decrease of cyclosporin trough levels in a compliant renal transplant patient. Nephrology Dialysis Transplantation, 2000. 15: p. 1473-1474.
6.???????? Rey, J. and G. Walter, Hypericum perforatum (St John's wort) in depression: pest or blessing? Med J Aust, 1998. 169: p. 583-586.
7.???????? Turton-Weeks, S., et al., St John's wort: a hidden risk for transplant patients. Progress in Transplantation, 2001. 11(2): p. 116-120.
8.???????? Barone, G., et al., Herbal supplements: a potential for drug interactions in transplant recipients. Transplantation, 2001. 71(2): p. 239-241.
9.???????? Breidenbach, T., et al., Drug interaction of St John's wort and cyclosporin. Lancet, 2000a. 355: p. 1912.
10.?????? Breidenbach, T., et al., Profound drop of cyclosporin A whole blood trough levels caused by St John's wort (hypericum perforatum). Transplantation, 2000b. 69(10): p. 2229-30.
11.?????? Ahmed, S., N. Banner, and S. Dubrey, Low cyclosporin-A level due to Saint-John's wort in heart transplant patients. Journal of Heart and Lung Transplantation, 2001. 20(7): p. 795.
12.?????? Ruschitzka, F., et al., Acute heart transplant rejection due to Saint John's wort. Lancet, 2000. 355: p. 548-549.
13.?????? Bolley, R., et al., Tacrolimus-induced nephrotoxicity unmasked by induction of the CYP3A4 system with St John's wort. Transplantation, 2002. 73(6): p. 1009-1011.
14.?????? Piscitelli, S., et al., Indinavir concentrations and St. John's wort. Lancet, 2000. 355: p. 547-548.
15.?????? Johne, A., et al., Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum). Clin Pharmacol Ther, 1999. 66: p. 338-345.
16.?????? Johne, A., Decreased plasma levels of amitryptyline and its metabolites on comedication with an extract from St. John's wort (Hypericum perforatum). Journal of Clinical Psychopharmacology, 2002. 22(1): p. 46-54.
17.?????? Lantz, M., E. Buchalter, and V. Giambanco, St John's wort and antidepressant drug interactions in the elderly. Journal of Geriatric Psychiatry and Neurology, 1999. 12: p. 7-10.
18.?????? Spinella, M. and L. Eaton, Hypomania induced by herbal and pharmaceutical psychotropic medicines following mild traumatic brain injury. Brain Injury, 2002. 16(4): p. 359-367.
19.?????? Gordon, J., SSRIs and St John's wort: possible toxicity? Am Family Phys, 1998. 57: p. 950-953.
20.?????? Will-Shahab, L., et al., St John's wort extract (Ze 117) does not alter the kinetics of a low-dose oral contraceptive. in press.
21.?????? Schwarz, U., B. Buschel, and W. Kirch, Unwanted pregnancy on self-medication with St John's wort despite hormonal contraception. British Journal of Clinical Pharmacology, 2003. 55: p. 112-113.
22.?????? Ernst, E., Second thoughts about the safety of St John's wort. Lancet, 1999. 354: p. 2014-2016.
23.?????? Schultz, V., Incidence and clinical relevance of the interactions and side effects of hypericum preparations. Phytomedicine., 2001. 8(2): p. 152-60.
24.?????? Maurer, A., A. Johne, and S. Bauer, Interaction of St John's wort with phenprocoumon (abstract). Eur J Clin Pharmacol, 1999. 55: p. A22.
25.?????? Yue, Q., C. Bergquist, and B. Gerden, Safety of St John's wort (Hypericum perforatum). Lancet, 2000. 355: p. 576-577.
26.?????? Carson, S., et al., Inhibitory effect of methanolic souloution of St. John's wort (Hypericum perforatum) on cytochrome P450 3A4 activity in human liver microsomes. Clin Pharmacol Ther, 2000. [abstract].
27.?????? Obach, R., Inhibition of human cytochrome P450 enzymes by constituents of St John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther, 2000. 294: p. 88-95.
28.?????? Budzinski, J.W., et al., An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine., 2000. 7(4): p. 273-82.
29.?????? Zou, L., M. Harkey, and G. Henderson, Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity. LIfe Sciences, 2002. 71: p. 1579-89.
30.?????? Noldner, M. and S. Chatterjee, Effects of two different extracts of SJW on Cytochrome P450 activities. Pharmacopsychiatry, 2001. 34(Suppl.1): p. S108-S110.
31.?????? Ereshefsky, B. Determination of St John's wort differential metabolism at CYP2D6 and CYP3A4, using dextromethorphan probe methodology. in Poster no. 130 presented at the 39th Annual Meeting of the New Clinical Drug Evaluation Unit Program. 1999. Florida.
32.?????? Gewertz, N. Determination of the differential effects of St John's wort on the CYP1A2 and NAT2 metabolic pathways using caffiene probe methodology. in Poster no. 131 presented at the 39th Annual Meeting of the New Clinical Drug Evaluation Unit Program. 1999. Florida.
33.?????? Markowitz, J., Effect of St John's wort (Hypericum perforatum) on cytochrome P450 2D6 and 3A4 activity in healthy volunteers. Life Sci, 2000. 66(9): p. 133-139.
34.?????? Roby, C., G. Anderson, and E. Kantor, St John's wort: Effect on CYP3A4 activity. Clin Pharmacol Ther, 2000. 67: p. 451-457.
35.?????? Durr, D., et al., St John's wort induces intestinal P-glycoprotein/MDR1 and intestinal and hepatic CYP3A4. Clinical Pharmacology and Therapeutics, 2000. 68: p. 598-604.
36.?????? Bray, B., et al., St. John's wort extract induces CYP3A and CYP2E1 in Swiss Webster Mouse. Toxicological Sciences, 2002. 66: p. 27-33.
37.?????? Gurley, B.J., et al., Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clinical Pharmacology & Therapeutics., 2002. 72(3): p. 276-87.
38.?????? Moore, L., et al., St. John's wort induces hepatic drug metabolism through activation of the pregnane X receptor. Proc Natl Acad Sci USA, 2000. 97(13): p. 7500-7502.
39.?????? Wentworth, J., St John's wort, a herbal antidepressant, activates the steroid X receptor. J Endocrinol, 2000. 166(3): p. R11-R16.
40.?????? Hennessy, M., et al., St John's wort increases expression of P-glycoprotein: Implications for drug interactions. Br J Clin Pharmacol, 2002. 53: p. 75-82.
41.?????? Perloff, M., et al., Saint John's wort: an in vitro analysis of P-glycoprotein induction due to extended exposure. British Journal of Pharmacology, 2001. 134(8): p. 1601-1608.
42.?????? Wang, Z., et al., Effect of St John's wort on the pharmacokinetics of fexofenadine. Clinical Pharmacology and Therapeutics, 2002. 71(6): p. 414-420.
43.?????? Barnes, J., L. Anderson, and J. Phillipson, Herbal Medicines. 2nd Edition ed. 2002, London: Pharmaceutical Press.
44.?????? Narhsted, A. Active constituents and quality of St. John's wort preparations. in Evidence-based herbal medicines: from tradition to clinic. 2002. Herbal Medicines Research and Education Centre, University of Sydney.

Regards little Locus!

danoEoboy said:

Sounds like a cure to premature ejaculation to me???

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Classic example of the glass half-empty half-full phenomenon. It's these differing ideas that keep this place spinning. 

danlennon3 said:

i too had the same problem with paxil. it might be cool that you can "stay in the game" for hours on end but you can tell it lowers your sex drive.. thats why i have been off paxil for years.. but now i dont have a girl so it doesnt matter

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I lost my girlfriend because of paroxetine (I always knew she was a slut at heart, it was just a matter of time) in part. Both because of the sexual side-effects, and because I was then ear marked as a mental case. She was a young bitch, she had ignorant and immature ideas.

I went psycho after that. I remember once when I was tearing my hair out, making threats with Hit em Up as background music. (not too loud, because then she couldn't hear the threats)

Locus, yes your right it has less side effects to the usual antidepressants.

Vornan said:

When did you quit lexapro?  Sometimes it just takes a very long time to normalize.  Are you taking anything now?

Vornan

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I quit taking it because I was tired of being in a lethargic, antisocial daze of fatigue and COMPLETE loss of sexual desire.  I started taking 900mg of St. John's Wort a few days ago...  I feel A LOT better although it's probably mainly due the the fact the SSRI withdrawal is withdrawing. 

Quote:

St. John's Wort has a mix of both SSRI and MAOI properties.

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Quote:

...although it's probably mainly due the the fact the SSRI withdrawal is withdrawing...

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bugfungii24 said:

You know SJW sounds alright!

Ill find out more about the dosage and the hyperforin contents and get started. (after tapering off Zoloft)

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alright now man, that sounds better