Posted by Sunnely on June 19, 2001, at 21:05:31
In reply to ST JOHNS WORT SIDE EFFECTS, posted by dana on June 18, 2001, at 19:24:06
Hi Dana,
As mentioned in the previous posts, St. John's Wort (SJW) or Hypericum perforatum, can interact with other serotonin-boosting drugs (e.g., the MAOIs, Prozac, Zoloft, Paxil, Serzone, the "triptans" for migraines, etc.) possibly causing "serotonin syndrome."
SJW can also induce the metabolism of certain drugs (via CYP3A4 and CYP2C9 induction) leading to their loss of effectiveness. Some of the serious drug-drug interactions with SJW are exemplified by:
1. SJW may increase the metabolism of oral contraceptives leading to decrease oral contraceptive blood concentrations, causing breakthrough bleeding, irregular menstrual bleeding and unwanted pregnancy;
2. SJW may increase the metabolism of cyclosporine leading decrease blood levels causing organ transplant rejection.
3. SJW might reduce the blood levels of digoxin (Lanoxin) leading to heart failure.
4. SJW might decrease the therapeutic effects of warfarin (Coumadin), a blood thinner, leading to thromboembolic complications.
5. SJW might reduce the blood levels of protease inhibitors (drugs for HIV) leading to development of viral resistance and treatment failure.
The following is a list of known and reported adverse reactions from the use of SJW:
1. Insomnia, vivid dreams, restlessness, anxiety, agitation, irritability, gastrointestinal discomfort, fatigue, dry mouth, dizziness, headache, paresthesias (e.g., numbness or tingling sensation), delayed hypersensitivity, induces hypomania or mania. In one report, insomnia was the most common side effect. In some cases, insomnia was alleviated by decreasing the dose or taking SJW in the morning.
2. Colic, drowsiness, and lethargy have been reported in breast-fed infants whose mothers used SJW while breast feeding.
3. SJW has been associated with reports of intermenstrual bleeding and one report of changed menstrual bleeding. Most of the women in these reports were taking an oral contraceptive and the changes in menstrual bleeding may be the result of a drug interaction.
4. Photodermatitis (skin rash from exposure to sunlight) and photosensitivity (skin senstivity) reported with use of SJW. Light or fair-skinned people should employ protective measures against direct sunlight when using SJW. Neuropathy after sun exposure has been reported.
5. There is some indication that SJW may be associated with a higher incidence of cataracts. The hypericin constituent is photoactive and, in the presence of light, may damage lens proteins, lealding to cataracts; however, studies evaluating this association are not available.
6. Some evidence suggests that high doses of SJW might reduce male and female fertility, but this effect has not been demonstrated in humans.
7. SJW might lead to withdrawal effects similar to those found with conventional antidepressants, including headache, nausea, dizziness, insomnia, paresthesias, confusion, and fatigue. In one report, withdrawal effects were most likely to occur within 2 days after discontinuation, but in some cases didn't occur for more than 1 week after stopping treatment. Occurrence of withdrawal symptoms did not appear to relate to dose or duration of use.
8. Finally, a case of hair loss due to SJW also reported.
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> I have just come off Zoloft after two years..... but felt a bit vulnerable without some sort of support. I tried half a tablet a day of St. Johns Wort for nearly two weeks, and was prepared to build up the dose gradually, however I found they seem to cause DIZZINESS !!......... the day I stopped taking them, the dizziness left.
>
> Has anyone experienced side-effects from using it ?
poster:Sunnely
thread:67005
URL: http://www.dr-bob.org/babble/20010618/msgs/67130.html