Lack of sleep, PMS, Depression? - St Johns Wort...

Discussion in 'Fibromyalgia Main Forum' started by PatPalmer, May 31, 2003.

  1. PatPalmer

    PatPalmer New Member

    I had not realised St Johns Wort is an antibacterial/viral agent too. - Learn something new every day...

    I am sorry to see several posts from some suffering with depression, i`ve been there, and things do improve, just seems like it never will at the time...

    This article gives a list of drug interactions too.

    Pat.

    St. John's wort (Hypericum perforatum), once thought to rid the body of evil spirits, has a history of medicinal use dating back to ancient Greece, where it was used to treat a range of illnesses, including various 'nervous conditions.' St. John's wort also has antibacterial and antiviral properties and, because of its anti-inflammatory properties, has been used to help heal wounds and burns.

    In recent years, there has been renewed interest in St. John's wort as a treatment for depression and there has been a great deal of scientific research on this topic. St. John's wort is one of the most commonly purchased herbal products in the United States. Because St. John's wort interacts with a wide variety of medications, it is important to take it only under the guidance of a healthcare provider who is knowledgeable about herbal medicines.

    Depression

    In numerous studies, St. John's wort has been effective in reducing depressive symptoms in those with mild to moderate but not severe (called major) depression. When compared with tricyclic anti-depressants (medication frequently prescribed for this condition) such as imipramine, amitriptyline, doxepin, desipramine, and nortriptyline, St. John's wort is equally effective, and has fewer side effects. This also appears to be true for another well known class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) including fluoxetine and sertraline.

    Other

    St. John's wort has also shown promise in treating the following conditions, a few of which are related to depression.

    Alcoholism: In animal studies, St. John's wort substantially reduced the craving for and intake of alcohol. It is hypothesized that alcohol abuse may be a form of self-medication and that, by relieving depressive symptoms, St. John's wort may reduce the perceived need for alcohol.
    Bacterial infections: In laboratory studies, St. John's wort has demonstrated the ability to fight certain infections, including some bacteria that are resistant to the effects of antibiotics. More research is needed in this area to understand if these test tube findings will prove useful for people.
    HIV infection and AIDS: While laboratory research suggests that St. John's wort may kill or inhibit the growth of human immunodeficiency virus (HIV; the virus that causes AIDS), St. John's wort has serious interactions with medications used to treat people with the virus. In the case of the protease inhibitor indinavir, for example, concurrent use of St. John's wort may cause the medication to lose its effectiveness. In addition, participants in a study of St. John's wort for people with HIV dropped out of the study prematurely because of intolerable side effects from the herb.
    Premenstrual syndrome (PMS): An early study suggests that St. John's wort may be useful in relieving both physical and emotional symptoms of PMS including cramps, irritability, food cravings, and breast tenderness.
    Seasonal affective disorder (SAD): Used alone, St. John's wort has improved mood in those suffering from SAD (a form of depression that occurs during the winter months because of lack of sunlight). This condition is often treated with photo (light) therapy. Effects may prove to be even greater when the herb is used in combination with light therapy.
    Viral encephalitis: Herbal specialists may recommend use of a tincture containing a combination of ginkgo, St. John's wort, and rosemary to relieve symptoms associated with recovery from brain inflammation (viral encephalitis) such as cognitive impairment, visual and speech disturbances, and difficulty performing routine functions.
    Wounds, minor burns, hemorrhoids: Topical St. John's wort is, at times, recommended by herbal specialists to reduce pain and inflammation and to promote healing by applying the agent directly to the skin. Preliminary laboratory tests are suggesting that this traditional use may have scientific merit.
    Ear pain from an ear infection: In a study of over 100 children between ages 6 and 18 with ear pain from an ear infection (called otitis media), a combination herbal ear drop, including St. John's wort, garlic, calendula, and mullein flower, alleviated pain as much as a standard pain killing ear drop.

    Plant Description

    St. John's wort is a shrubby plant with clusters of yellow flowers that have oval, elongate petals. The plant gets its name because it is often in full bloom around June 24, the day traditionally celebrated as the birthday of John the Baptist. Both the flowers and leaves are used for medicinal purposes.

    What's It Made Of?

    The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. There has been recent research to suggest, though, that these best-studied components may not be the most active in the plant, which also contains essential oils and flavonoids.

    Available Forms

    St. John's wort can be obtained in many forms: capsules, tablets, tinctures, teas, and oil-based skin lotions. Chopped or powdered forms of the dried herb are also available. St. John's wort products should be standardized to contain 0.3% hypericin.

    How to Take It

    Pediatric

    The bulk of scientific research on St. John's wort has been conducted in adults. However, one large study (over 100 children under age 12) found St. John's wort to be a safe and effective way of treating mild to moderate symptoms of depression in children. Dosage should be directed by a qualified practitioner and will likely be adjusted according to the weight of the child. Children being treated with St. John's wort should be carefully monitored for side effects such as allergic reactions or digestive upset.

    Adult

    Dry herb (in capsules or tablets): The usual dose for mild depression and mood disorders is 300 to 500 mg (standardized to 0.3% hypericin extract), three times per day, with meals.
    Liquid extract (1:1): 40 to 60 drops, two times per day.
    Tea: Pour one cup of boiling water over 1 to 2 tsp of dried St. John's wort and steep for 10 minutes. Drink up to 2 cups per day for four to six weeks.
    Oil or cream: To treat inflammation, as in wounds, burns or hemorrhoids, an oil-based preparation of St. John's wort can be applied topically.
    Internal dosages generally require at least eight weeks to get the full therapeutic effect.


    Precautions

    The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

    Many people take St. John's wort for depression. It is important to bear in mind that depression can be a serious condition and may be accompanied by thoughts of suicide or homicide, both of which warrant immediate medical attention. Evaluation by a healthcare professional should always be sought before using St. John's wort.

    Potential side effects from St. John's wort are generally mild. They include stomach upset, hives or other skin rash, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. Although not common, St. John's wort can also make the skin overly sensitive to sunlight (called photodermatitis). Those with light skin who are taking St. John's wort in large doses or over a long period of time should be particularly careful about sun exposure. The use of sunscreen with a skin protection factor (SPF) of at least 15, and the avoidance of sunlamps, tanning booths, or tanning beds is recommended while taking St. John's wort.

    Because of the potential for serious interaction with medications used during surgery, patients should discontinue the use of St. John's wort at least 5 days prior to surgery and should avoid taking it post surgery. See Possible Interactions for more information about mixing St. John's wort and medications.

    St. John's wort should not be taken by women who are pregnant, trying to become pregnant, or breastfeeding.

    Possible Interactions

    St. John's wort interacts with a range of medications. In most cases, this interactions leads to reduced the effectiveness of the medication in question; in other cases, however, St. John's wort may increase the effects of a medication.

    If you are currently being treated with any of the following medications, you should not use St. John's wort without first talking to your healthcare provider:

    Antidepressants
    St. John's wort may interact with antidepressant medications that are used to treat depression or other mood disorders, including tricyclics, SSRIs (see earlier discussion), and monoamine oxidase inhibitors (MAOIs) such as phenelzine. How St. John's wort works is not entirely clear, but is believed to be similar to how SSRIs work. Therefore, using St. John's wort with this class of antidepressants in particular can lead to exacerbation of side effects including headache, dizziness, nausea, agitation, anxiety, lethargy, and lack of coherence.

    Digoxin
    St. John's wort should not be taken by those on digoxin because the herb may decrease levels of the medication and reduce its effectiveness.

    Immunosuppressive medications
    St. John's wort should not be taken by those on immunosuppressive medications such as cyclosporine because it may reduce the effectiveness of these medications. In fact, there have been many reports of cyclosporin blood levels dropping in those with a heart or kidney transplant, even leading to rejection of the transplanted organ.

    Indinavir and other protease inhibitors
    The Food and Drug Administration (FDA) issued a public health advisory in February 2000 concerning the probable interaction between indinavir and St. John's wort that resulted in significantly decreased blood levels of this protease inhibitor, a class of medications used to treat HIV or AIDS. The FDA recommends that St. John's wort not be used with any type of antiretroviral medication used to treat HIV or AIDS.

    Loperamide
    There has been a report of a possible interaction between St. John's wort and the antidiarrheal medication, loperamide leading to delirium in an otherwise healthy woman.

    Oral contraceptives
    There have been reports of breakthough bleeding in women on birth control pills who were also taking St. John's wort.

    Reserpine
    Based on animal studies, St. John's wort may interfere with the intended action of this medication used to treat high blood pressure.

    Theophylline
    St. John's wort can reduce levels of this medication in the blood leading. Theophylline is used to open the airways in those suffering from asthma, emphysema, or chronic bronchitis.

    Warfarin
    St. John's wort interferes with the anticoagulant medication, warfarin, by reducing blood levels as well as the effectiveness. This leads to the need to for adjustments in doses of this medication.


  2. TNhayley

    TNhayley New Member

    and my doc gave me a list of things I should avoid. There appears to be some debate about this but FYI (found this info on all-natural.) Hugs, Hayley

    Dr. Donald Brown of Bastyr University recommends that persons with fair skin avoid exposure to strong sunlight and other sources of ultraviolet light when taking St. John's Wort because of some cases of photosensitivity that have been reported. He also advises avoiding foods that contain tyramine, alcoholic beverages, and medications such as tyrosine, narcotics, amphetamines, and over-the-counter cold and flu remedies while taking St. John's Wort. St. John's Wort should not be taken while also taking prescription antidepressants. It is also Dr. Brown's opinion that St. John's Wort should not be used during pregnancy or lactation.

    According to Jonathan Zuess, MD (author of The Natural Prozac Program), tyramine seems to primarily be a problem if a person has high blood pressure. This is due to St. John's Wort working in a similar way to drugs that are monoamine oxidase inhibitors (MAOIs).

    However, studies done in the 1990's have shown that the MAOI-like effect of St. John's Wort is negligible when it's used in normal doses. So it is unlikely that it would react with tyramine. In Germany, where doctors have had the most experience with St. John's Wort, it is considered safe to use in patients with high blood pressure.

    Nonetheless, if you have high blood pressure, and your doctor agrees to your use of St. John's Wort, the following precautions should be taken:

    Have your blood pressure checked at least weekly for the first six weeks, and at least monthly thereafter.

    Do not eat foods containing tyramine.

    Even if you do not have high blood pressure, do not take St. John's Wort with amino acid supplements (especially phenylalanine and tyrosine). Amino acids are a form of monoamines, which can pose a danger when mixed with St. John's Wort. The monoamines that you get in your diet (such as the amino acids in meat) are less concentrated and are not a hazard.

  3. lucky

    lucky New Member

    There is a big debate whether St. John's Wort is effective at all and recent studies have shown that it does not help depression. I rather tend to agree with this study, however, we all have different opinions on some of the supplements.
    Sincerely, Lucky
  4. layinglow

    layinglow New Member

    Thank you Pat, this is a very good article. I am so relieved, and pleased to see the contra-indications also listed with the positive benefits. So often, many assume that because something is "natural" or herbal, that it is entirely safe. One must always remember, however that modern pharmacology developed from these various herbs. They do contain substances, that can have adverse effects for some.

    Many times as well, the research and clinical trials are lacking in these remedies, and research into use with pharmeceuticals is very limited. Thank you for posting this, especially in this form with the adverse effects listed.

    It is so easy for a consumer to obtain these remedies, without literature (as is received with a prescription drug), and without the assistance of a practicioner who is knowledgeable, or without doing extensive research that is difficult to find due to the lack of it, that they can be a hazard.

    Herbs are composed of the same active ingredients that many of our pharmeceuticals contain. A patient must always be informed, when using either.

    Thank you so much!
    Karen
  5. judywhit

    judywhit New Member

    Yes, there are side effects and we need to be educated about anything we put in our bodies. But, I believe that we should be more willing to use the natural herbs than take the scripts. Most doctors never monotor their patients who are on the SSRI's nor the neurontin. We must be our own health advocate. SJW helps for depression!!! I would love to see the study that states "doubt" The big drug companys behind it perhaps?
    Thanks for the article Pat. You mentioned in your title "sleep" does SJW help with this too? I did not catch that in the article.
    Judy
  6. CelticLadee

    CelticLadee New Member

    Yes, I have been taking SJW since December 2002. My naturopath told me it is a good anti-viral and it is among my arsenal to kill the beasties. He did warn me about sun exposure while taking it because I do have fair skin. I haven't noticed that it helps with depression though. I get depressed once in awhile with or without it. Generally speaking I haven't had a real problem with depression though. This article is very informative and I appreciate you sharing it with everyone today. Thank you Pat. C.LaDee
  7. lucky

    lucky New Member

    the study on St. Johns' Wort was a scientific one and I should have kept a copy of it. This study was not done by any big multi drug company as far as I remember. And, don't forget how much money the manufacturers of supplements are making because of people believing that they are the answer to all of their health problems.
    Sincerely, Lucky

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