Mind is also a good place for info on coming off anti-ds here - it's a mental health charity here in UK but info should be the same- has more info about tapering off the different anti-ds as well as prozac and support strategies, etc.
https://www.mind.org.uk/information-sup ... qgyFjKcZsM
On the left the tabs give more info about different aspects
Please note I have tapered mine for a while and was a low dose to start with, they are all different and probably best to consult with a doctor before making any changes, and cutting down slowly.
Here is a nice article I reads about someone coming off with the support of some supplements.
https://www.wellandgood.com/good-advice ... y/slide/4/
Serotonin, Depression and SSRI Antidepressants
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
Re: Serotonin, Depression and SSRI Antidepressants
That's interesting. Just got a blood test back for liver function as ALT was high 3 months ago. Since stopping the prozac and starting the Curcumin, it is now normal. Has dropped from 69 to 22 (normal range 10 to 40). Pleased with that. All other liver results normal too. I noticed in the study on Longveda it did reduce ALT. While long term use of meds such as prozac can in some cases cause liver damage. I mean it could be other things, but can't think of other changes during this time.
Re: Serotonin, Depression and SSRI Antidepressants
I just finished reading Lost Connections, which gave me insights on how antidepressants have been marketed and prescribed, instead of reflecting on root causes. It's been ingrained that depression is low serotonin, etc, hence these pills restore the balance. According to my genetic reports, I am prone to side effects and poor efficacy with SSRis, at the time disappointing should I ever need them, so I'm relieved. However, like most drugs, there is a subset that do strongly respond. Hari who was on SSRI for over 13 years, puts forth a more life/community connection as the the etiology of depression.
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
Re: Serotonin, Depression and SSRI Antidepressants
KatieS wrote:I just finished reading Lost Connections, which gave me insights on how antidepressants have been marketed and prescribed, instead of reflecting on root causes. It's been ingrained that depression is low serotonin, etc, hence these pills restore the balance. According to my genetic reports, I am prone to side effects and poor efficacy with SSRis, at the time disappointing should I ever need them, so I'm relieved. However, like most drugs, there is a subset that do strongly respond. Hari who was on SSRI for over 13 years, puts forth a more life/community connection as the the etiology of depression.
Yes, I know what you mean. Maybe low serotonin is a symptom not a cause...that might make sense, but not be the whole picture. I know with me the cause was basically stress, being in my final year of studies, family stuff, working in the university canteen to pay for it, they actually said it was like a 'burnout' rather than depression. But it was the late 90s when these meds were just coming out, was about 5 mins in the docs before they sent me off with a prescription and an extension on my deadlines.
Yes i noticed I also have some of those snaps you mention, but it seemed to work OK for me. Although I have had problems with them now eating more healthy etc, and also had problems with other things like some supplements.
In case you do ever have problems with depression, there are lots of non-med things to do such as supplements like 5HTP, fish oil, or St John's Wort, Curcumin for example and things like CBT, and mindfulness can really help too. https://www.psychologytoday.com/blog/ow ... the-prozac
On the psychology side I like this TED talk here about power, and visualisation https://www.psychologytoday.com/blog/re ... o-about-it
I think lots of the things people are doing here anyway would probably be preventative anyway.
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
Re: Serotonin, Depression and SSRI Antidepressants
Day ten here today and feeling quite shaky and odd, but thankfully my mind seems OK, quite calm really.
We talked earlier in this post about the idea that antidepressants can damage the brain and I have found out something more about this. We also discussed that dementia can be associated with low serotonin levels and that depression and antidepressants may be associated with the onset of dementia.
Just been reading this link about withdrawal https://www.psychologytoday.com/blog/si ... l-syndrome and read-
"while this class of drugs artificially raises the amount of serotonin in the brain, the serotonergic system doesn't ignore the increase, but adjusts to and compensates for it, downregulating the number of 5-HT1A receptors because the drugs, altering serotonin levels, put them in less demand. At the same time, the serotonergic system needs more 5-HT2 receptors to soak up the excess of the messenger, a situation many studies have linked to patients' widespread complaints of sexual dysfunction, because those receptors send saturation signals to the brain. In 2002, in the International Journal of Neuropsychopharmacology, to invoke just one study, Adam Opbroek and his colleagues found that "80% of patients with SSRI-induced sexual dysfunction also describe clinically significant blunting of several emotions" (p. 147).
When patients try to end treatment, even stepping down their dose very gradually, many of them (22% to 78%, according to Rosenbaum and Fava) find that the receptors in their serotonergic system—saturated artificially for months, even years—experience the drop to pre-drug levels as starvation. Some patients then find themselves at the mercy of hair-trigger symptoms that register as intense anxiety, aggression, and insomnia.
Several receptors—including 5-HT1A—aren't especially malleable, moreover, and take longer to sprout anew after drug treatment ends, delaying the patient's return to neuronal health. Indeed, some studies I consulted found that in certain patients those receptors fail to grow back at all, in effect leaving the patients worse off than before. (See for instance "Dissociation of the Plasticity of 5-HT1A Sites and 5-HT Transporter Sites (link is external)" in Paxil Research Studies 19.3 [1994], 311-15.)"
I wonder if this could be a link to dementia? Not sure. So- have to hope mine might grow back with time, I guess. But I'm sorry I was dismissive of this idea originally. It seems it is a problem and something to be aware of with regard to these meds.
This was helpful though: (in regard to someone coming off the meds) and reminded me of the brains plasticity and capability of recovery and change. http://www.nytimes.com/2007/05/06/magaz ... wanted=all
"Ron Duman, a researcher at the Yale University School of Medicine in the psychiatry department, told me recently that there was no specific mechanism that would explain my symptoms, but that my system was trying to readapt.
“Your neurons,” he said, “are literally sensing the lack of serotonin.” That was the bad news. The good news: “That the brain is able to adapt to stress, to environmental impact or pharmacological stimuli and change over time is really a key concept of how the brain works.”"
On a more positive note, I am really noticing the Longvida Curcumin helping with these withdrawal symptoms, I'm taking two a day at the mo. Another thing is magnesium is really helping with sleep and no brain zaps this time. having epsom salts and lavender in the bath in the evening is relaxing, as is walking. Maybe this will increase the serotonin levels a little so the receptors can sort themselves out a bit. Fingers crossed.
We talked earlier in this post about the idea that antidepressants can damage the brain and I have found out something more about this. We also discussed that dementia can be associated with low serotonin levels and that depression and antidepressants may be associated with the onset of dementia.
Just been reading this link about withdrawal https://www.psychologytoday.com/blog/si ... l-syndrome and read-
"while this class of drugs artificially raises the amount of serotonin in the brain, the serotonergic system doesn't ignore the increase, but adjusts to and compensates for it, downregulating the number of 5-HT1A receptors because the drugs, altering serotonin levels, put them in less demand. At the same time, the serotonergic system needs more 5-HT2 receptors to soak up the excess of the messenger, a situation many studies have linked to patients' widespread complaints of sexual dysfunction, because those receptors send saturation signals to the brain. In 2002, in the International Journal of Neuropsychopharmacology, to invoke just one study, Adam Opbroek and his colleagues found that "80% of patients with SSRI-induced sexual dysfunction also describe clinically significant blunting of several emotions" (p. 147).
When patients try to end treatment, even stepping down their dose very gradually, many of them (22% to 78%, according to Rosenbaum and Fava) find that the receptors in their serotonergic system—saturated artificially for months, even years—experience the drop to pre-drug levels as starvation. Some patients then find themselves at the mercy of hair-trigger symptoms that register as intense anxiety, aggression, and insomnia.
Several receptors—including 5-HT1A—aren't especially malleable, moreover, and take longer to sprout anew after drug treatment ends, delaying the patient's return to neuronal health. Indeed, some studies I consulted found that in certain patients those receptors fail to grow back at all, in effect leaving the patients worse off than before. (See for instance "Dissociation of the Plasticity of 5-HT1A Sites and 5-HT Transporter Sites (link is external)" in Paxil Research Studies 19.3 [1994], 311-15.)"
I wonder if this could be a link to dementia? Not sure. So- have to hope mine might grow back with time, I guess. But I'm sorry I was dismissive of this idea originally. It seems it is a problem and something to be aware of with regard to these meds.
This was helpful though: (in regard to someone coming off the meds) and reminded me of the brains plasticity and capability of recovery and change. http://www.nytimes.com/2007/05/06/magaz ... wanted=all
"Ron Duman, a researcher at the Yale University School of Medicine in the psychiatry department, told me recently that there was no specific mechanism that would explain my symptoms, but that my system was trying to readapt.
“Your neurons,” he said, “are literally sensing the lack of serotonin.” That was the bad news. The good news: “That the brain is able to adapt to stress, to environmental impact or pharmacological stimuli and change over time is really a key concept of how the brain works.”"
On a more positive note, I am really noticing the Longvida Curcumin helping with these withdrawal symptoms, I'm taking two a day at the mo. Another thing is magnesium is really helping with sleep and no brain zaps this time. having epsom salts and lavender in the bath in the evening is relaxing, as is walking. Maybe this will increase the serotonin levels a little so the receptors can sort themselves out a bit. Fingers crossed.
Re: Serotonin, Depression and SSRI Antidepressants
St Johns wort is a potent mono-amine oxidase inhibitor (MAOI). It has multiple unpredictable interactions. I'd take an SSRI any day over it.
Just because its made by a plant doesnt mean its innocuous. Deadly nightshade. Oleander leaves. Monkshood. Lawn mushroom/ Deathcap/ Skullcap (technically not plants I know).
Sent from my SM-G930F using Tapatalk
Just because its made by a plant doesnt mean its innocuous. Deadly nightshade. Oleander leaves. Monkshood. Lawn mushroom/ Deathcap/ Skullcap (technically not plants I know).
Sent from my SM-G930F using Tapatalk
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
Re: Serotonin, Depression and SSRI Antidepressants
Thanks Stavia, to be honest I have never tried it. I was just mentioning it as had seen it mentioned as something to try. Thanks for clarifying.Stavia wrote:St Johns wort is a potent mono-amine oxidase inhibitor (MAOI). It has multiple unpredictable interactions. I'd take an SSRI any day over it.
Just because its made by a plant doesnt mean its innocuous. Deadly nightshade. Oleander leaves. Monkshood. Lawn mushroom/ Deathcap/ Skullcap (technically not plants I know).
Sent from my SM-G930F using Tapatalk
Re: Serotonin, Depression and SSRI Antidepressants
It has that reputation, but it does not seem to be founded in fact. FromStavia wrote:St Johns wort is a potent mono-amine oxidase inhibitor (MAOI).
Monoamine oxidase A inhibitor occupancy during treatment of major depressive episodes with moclobemide or St. John’s wort: an [11C]-harmine PET study
(Emphasis added.)Sacher, et al wrote:
Results
We included 23 participants (10 controls and 13 patients with major depressive disorder [MDD]) in our study. Monoamine oxidase A VT decreased significantly throughout all regions after moclobemide treatment in patients with MDD compared with controls (repeated-measures analysis of variance, F1,15 = 71.08–130.06, p < 0.001 for all regions, mean occupancy 74% [standard deviation 6%]). Treatment with St. John’s wort did not significantly alter MAO-A VT.
From my close secondhand experience with SSRIs, which has motivated me to develop a great deal more remote secondhand experience, I would not recommend taking an SSRI over any substance that is not acutely poisonous. So that's my bias - from what I see, SJW has difficult withdrawal symptoms just like SSRIs do. I think the differences between them are subtle relative to the fundamental reality that they both alter brain chemistry to a degree that can be very very difficult to undo.It has multiple unpredictable interactions. I'd take an SSRI any day over it.
Re: Serotonin, Depression and SSRI Antidepressants
Fair enough, youve had a bad experience with SSRIs. Which I have occasionally seen.
I have had hundreds of patients safely on and off them over the years. But I dont prescribe them nilly willy.
I mistakenly remembered MAOI when its the cytochrome pathway. Thanks for correcting me.
http://www.medsafe.govt.nz/Profs/PUarticles/sjw.htm
"Complementary healthcare products containing St John's wort are available through direct marketing and from pharmacies, health food shops, supermarkets and complementary healthcare practitioners. They are used for a variety of conditions including the symptoms of depression. A number of clinical trials published in peer reviewed journals have commented favourably on the safety and efficacy of products containing standardised extracts of this botanical substance.
A recently published study1 found a clinically significant reduction in serum levels of indinavir, a protease inhibitor used to treat HIV infection, when it was used with a St John's wort preparation. A second article2 described two cases of heart transplant rejection in patients taking St John's wort with cyclosporin. There had previously been individual reports suggesting interactions with other medicines may be occurring. There have, however, been no reported deaths associated with use of St John's wort.
Why do St John's wort preparations interact with other medicines?
It appears that St John's wort preparations may interact with medicines either by increasing the rate of their metabolism or increasing levels of neurotransmitters. The effect on metabolism appears to occur by induction of certain cytochrome P450 isoenzymes in the liver and gut (particularly CYP 3A4, but also 1A2 and 2C9) reducing the blood levels and effectiveness of some medicines.
Many medicines, including carbamazepine and phenytoin, are potent enzyme inducers which act at the CYP 3A4 site. Several naturally occurring substances including grapefruit juice, red wine and broccoli have also been found to have effects on these enzyme systems.3
St John's wort may also increase the levels in the brain of the neurotransmitter serotonin by an additive or potentiating effect on other medicines. Medicines which may interact with St John's wort in this way include the selective serotonin reuptake inhibitor (SSRI) antidepressants (e.g. fluoxetine, paroxetine), other antidepressants affecting serotonin levels (e.g. nefazodone), and some migraine treatments (e.g. sumatriptan, naratriptan). These additive interactions may result in a variety of symptoms such as mental state changes, autonomic dysfunction (sweating, increased blood pressure) and motor effects consistent with increased serotonin.
Which medicines interact with St John's wort?
The table below lists medicines for which there is varying degrees of evidence of a possible interaction with St John's wort. For some (e.g. cyclosporin, warfarin, indinavir, carbamazepine) the loss of clinical effectiveness is potentially serious. The table gives an indication of the nature and strength of the evidence of interaction, describes the effect of an interaction should it occur, and provides advice on the management of patients. For some of the medicines listed there is at present no more than a theoretical possibility of interaction.
The table is not exhaustive, but it covers the information available to date. Other medicines not included in this list therefore may also interact with St John's wort preparations. In general, the following medicines are not likely to interact with St John's wort preparations:
topical medicines with limited systemic absorption (inhalers, skin creams and ointments, eye and ear drops, enemas etc.)non-psychotropic medicines which are principally renally excretedHow should patients be managed?
The levels of active ingredients within products containing St John's wort may vary from batch to batch and from one preparation to another. The degree of interaction with prescribed medicines may also vary. Hence, for some conditions the table advises discontinuing St John's wort. For these patients, in light of the currently available information, it is not advisable to attempt to stabilise them on suitable doses of a St John's wort preparation and the medication treating the condition.
When patients stop taking St John's wort preparations, the loss of enzyme induction may result in increased blood levels of interacting medicines possibly leading to toxicity. Any toxicity may take several days to present.
Those who need to stop St John's wort should have the management of their depression reviewed.
Reporting suspected interactions
Medical practitioners and pharmacists are asked to report suspected interactions, and adverse reactions, to St John's wort to the Centre for Adverse Reactions Monitoring, University of Otago, PO Box 913, Dunedin. Copies of the reporting form can be obtained from the Centre at the above address or can be downloaded from this web site.
MEDICINES INTERACTING WITH ST JOHN'S WORT (SJW)Patients taking these medicines should not start taking St John's wort preparations without seeking medical adviceMedicineEvidence baseEvidence and effect of interactionSuggested management of patients already taking St John's wort preparationsHIV protease inhibitors
(indinavir, nelfinavir, ritonavir, saquinavir)StrongA clinical study has demonstrated reduced blood levels with possible loss of HIV suppression.Measure HIV RNA viral load and stop SJW. Review management of depression.Immunosuppressants
(cyclosporin, tacrolimus)StrongCase reports have demonstrated reduced blood levels with transplant rejection.Check cyclosporin or tacrolimus blood levels and stop SJW. Levels may increase on stopping SJW. The dose of immunosuppressant may need adjusting. Review management of depression.HIV non-nucleoside reverse transcriptase inhibitors
(efavirenz, nevirapine, delavirdine)TheoreticalReduced blood levels with possible loss of HIV suppression is theoretically possible.Measure HIV RNA viral load and stop SJW. Review management of depressionWarfarinModerateCase reports of reduced anticoagulant effect and need for increased warfarin dose have been reported.Check INR and stop SJW. Monitor INR closely as this may rise on stopping SJW. The dose of warfarin may need adjusting. Review management of depressionAnticonvulsants (carbamazepine, phenobarbitone, phenytoin)TheoreticalReduced blood levels with risk of seizures theoretically possible.Check anticonvulsant levels and stop SJW. Anticonvulsant levels may increase on stopping SJW. The dose of anticonvulsant may need adjusting. Review management of depressionDigoxinModerateIsolated case reports of reduced blood levels have been reported. Theoretical loss of control of heart rhythm or heart failure.Check digoxin levels and stop SJW. Digoxin levels may increase on stopping SJW. The dose of digoxin may need adjusting. Review management of depression.SSRIs and related antidepressants
(citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, nefazodone)ModerateSmall numbers of case reports of increased serotonergic effects have been reported.Weigh the benefits of continuing SJW against possible adverse effects. Review management of depression.Triptans (sumatriptan, naratriptan, rizatriptan, zolmitriptan)WeakIncreased serotonergic effects with increased chance of adverse reactions theoretically possible.Weigh the benefits of continuing SJW against possible adverse effects. Review management of depression.Oral contraceptivesWeakSmall numbers of case reports of breakthrough bleeding, contraceptive failure theoretically possible but no case reports of contraceptive failure have been reported.Weigh the benefits of continuing SJW against theoretical possibility of reduced contraceptive efficacy. Review management of depression.TheophyllineTheoreticalReduced blood levels and loss of bronchodilator effect theoretically possible.Check theophylline levels and review use of SJW. Weigh the benefits of continuing SJW against possible adverse effects. Theophylline levels may increase on stopping SJW. The dose of theophylline may need adjusting. Review management of depression.
Note: Other medicines not included in this list may also interact with St John's wort."
Sent from my SM-G930F using Tapatalk
I have had hundreds of patients safely on and off them over the years. But I dont prescribe them nilly willy.
I mistakenly remembered MAOI when its the cytochrome pathway. Thanks for correcting me.
http://www.medsafe.govt.nz/Profs/PUarticles/sjw.htm
"Complementary healthcare products containing St John's wort are available through direct marketing and from pharmacies, health food shops, supermarkets and complementary healthcare practitioners. They are used for a variety of conditions including the symptoms of depression. A number of clinical trials published in peer reviewed journals have commented favourably on the safety and efficacy of products containing standardised extracts of this botanical substance.
A recently published study1 found a clinically significant reduction in serum levels of indinavir, a protease inhibitor used to treat HIV infection, when it was used with a St John's wort preparation. A second article2 described two cases of heart transplant rejection in patients taking St John's wort with cyclosporin. There had previously been individual reports suggesting interactions with other medicines may be occurring. There have, however, been no reported deaths associated with use of St John's wort.
Why do St John's wort preparations interact with other medicines?
It appears that St John's wort preparations may interact with medicines either by increasing the rate of their metabolism or increasing levels of neurotransmitters. The effect on metabolism appears to occur by induction of certain cytochrome P450 isoenzymes in the liver and gut (particularly CYP 3A4, but also 1A2 and 2C9) reducing the blood levels and effectiveness of some medicines.
Many medicines, including carbamazepine and phenytoin, are potent enzyme inducers which act at the CYP 3A4 site. Several naturally occurring substances including grapefruit juice, red wine and broccoli have also been found to have effects on these enzyme systems.3
St John's wort may also increase the levels in the brain of the neurotransmitter serotonin by an additive or potentiating effect on other medicines. Medicines which may interact with St John's wort in this way include the selective serotonin reuptake inhibitor (SSRI) antidepressants (e.g. fluoxetine, paroxetine), other antidepressants affecting serotonin levels (e.g. nefazodone), and some migraine treatments (e.g. sumatriptan, naratriptan). These additive interactions may result in a variety of symptoms such as mental state changes, autonomic dysfunction (sweating, increased blood pressure) and motor effects consistent with increased serotonin.
Which medicines interact with St John's wort?
The table below lists medicines for which there is varying degrees of evidence of a possible interaction with St John's wort. For some (e.g. cyclosporin, warfarin, indinavir, carbamazepine) the loss of clinical effectiveness is potentially serious. The table gives an indication of the nature and strength of the evidence of interaction, describes the effect of an interaction should it occur, and provides advice on the management of patients. For some of the medicines listed there is at present no more than a theoretical possibility of interaction.
The table is not exhaustive, but it covers the information available to date. Other medicines not included in this list therefore may also interact with St John's wort preparations. In general, the following medicines are not likely to interact with St John's wort preparations:
topical medicines with limited systemic absorption (inhalers, skin creams and ointments, eye and ear drops, enemas etc.)non-psychotropic medicines which are principally renally excretedHow should patients be managed?
The levels of active ingredients within products containing St John's wort may vary from batch to batch and from one preparation to another. The degree of interaction with prescribed medicines may also vary. Hence, for some conditions the table advises discontinuing St John's wort. For these patients, in light of the currently available information, it is not advisable to attempt to stabilise them on suitable doses of a St John's wort preparation and the medication treating the condition.
When patients stop taking St John's wort preparations, the loss of enzyme induction may result in increased blood levels of interacting medicines possibly leading to toxicity. Any toxicity may take several days to present.
Those who need to stop St John's wort should have the management of their depression reviewed.
Reporting suspected interactions
Medical practitioners and pharmacists are asked to report suspected interactions, and adverse reactions, to St John's wort to the Centre for Adverse Reactions Monitoring, University of Otago, PO Box 913, Dunedin. Copies of the reporting form can be obtained from the Centre at the above address or can be downloaded from this web site.
MEDICINES INTERACTING WITH ST JOHN'S WORT (SJW)Patients taking these medicines should not start taking St John's wort preparations without seeking medical adviceMedicineEvidence baseEvidence and effect of interactionSuggested management of patients already taking St John's wort preparationsHIV protease inhibitors
(indinavir, nelfinavir, ritonavir, saquinavir)StrongA clinical study has demonstrated reduced blood levels with possible loss of HIV suppression.Measure HIV RNA viral load and stop SJW. Review management of depression.Immunosuppressants
(cyclosporin, tacrolimus)StrongCase reports have demonstrated reduced blood levels with transplant rejection.Check cyclosporin or tacrolimus blood levels and stop SJW. Levels may increase on stopping SJW. The dose of immunosuppressant may need adjusting. Review management of depression.HIV non-nucleoside reverse transcriptase inhibitors
(efavirenz, nevirapine, delavirdine)TheoreticalReduced blood levels with possible loss of HIV suppression is theoretically possible.Measure HIV RNA viral load and stop SJW. Review management of depressionWarfarinModerateCase reports of reduced anticoagulant effect and need for increased warfarin dose have been reported.Check INR and stop SJW. Monitor INR closely as this may rise on stopping SJW. The dose of warfarin may need adjusting. Review management of depressionAnticonvulsants (carbamazepine, phenobarbitone, phenytoin)TheoreticalReduced blood levels with risk of seizures theoretically possible.Check anticonvulsant levels and stop SJW. Anticonvulsant levels may increase on stopping SJW. The dose of anticonvulsant may need adjusting. Review management of depressionDigoxinModerateIsolated case reports of reduced blood levels have been reported. Theoretical loss of control of heart rhythm or heart failure.Check digoxin levels and stop SJW. Digoxin levels may increase on stopping SJW. The dose of digoxin may need adjusting. Review management of depression.SSRIs and related antidepressants
(citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, nefazodone)ModerateSmall numbers of case reports of increased serotonergic effects have been reported.Weigh the benefits of continuing SJW against possible adverse effects. Review management of depression.Triptans (sumatriptan, naratriptan, rizatriptan, zolmitriptan)WeakIncreased serotonergic effects with increased chance of adverse reactions theoretically possible.Weigh the benefits of continuing SJW against possible adverse effects. Review management of depression.Oral contraceptivesWeakSmall numbers of case reports of breakthrough bleeding, contraceptive failure theoretically possible but no case reports of contraceptive failure have been reported.Weigh the benefits of continuing SJW against theoretical possibility of reduced contraceptive efficacy. Review management of depression.TheophyllineTheoreticalReduced blood levels and loss of bronchodilator effect theoretically possible.Check theophylline levels and review use of SJW. Weigh the benefits of continuing SJW against possible adverse effects. Theophylline levels may increase on stopping SJW. The dose of theophylline may need adjusting. Review management of depression.
Note: Other medicines not included in this list may also interact with St John's wort."
Sent from my SM-G930F using Tapatalk
-
- Senior Contributor
- Posts: 802
- Joined: Tue Nov 07, 2017 10:11 am
Re: Serotonin, Depression and SSRI Antidepressants
I've not had a bad experience with SSRI's, in fact they helped me a lot. I'm just unsure about their link to AD and therefore coming off them. It seems quite common to have some withdrawal effects as i'm having now, hopefully it won't last long.
St John's Wort is available everywhere in the UK and seems to be recommended by Mind, who I usually trust as a reliable source. I didn't realise the bad points, and would never try and recommend anything dodgy. It is available everywhere here in the UK usually for seasonal affective disorder. It is rather expensive so think that may be why i have avoided trying it in the past. Thank you for explaining further and about the interactions.
I can't understand if it is so unsafe why it would be for sale everywhere here. Bit worrying
See https://www.mind.org.uk/information-sup ... qth6zKcZsM
They give a fact sheet /pdf also. here
https://www.mind.org.uk/media/5460408/s ... eb-pdf.pdf
I also found this sheet on depression from the charity Food for the Brain- so similar to some of the nutritional supplements and advice for AD prevention. In case is of use to anyone.
http://www.foodforthebrain.org/nutritio ... ssion.aspx
St John's Wort is available everywhere in the UK and seems to be recommended by Mind, who I usually trust as a reliable source. I didn't realise the bad points, and would never try and recommend anything dodgy. It is available everywhere here in the UK usually for seasonal affective disorder. It is rather expensive so think that may be why i have avoided trying it in the past. Thank you for explaining further and about the interactions.
I can't understand if it is so unsafe why it would be for sale everywhere here. Bit worrying
See https://www.mind.org.uk/information-sup ... qth6zKcZsM
They give a fact sheet /pdf also. here
https://www.mind.org.uk/media/5460408/s ... eb-pdf.pdf
I also found this sheet on depression from the charity Food for the Brain- so similar to some of the nutritional supplements and advice for AD prevention. In case is of use to anyone.
http://www.foodforthebrain.org/nutritio ... ssion.aspx