Posted by Larry Hoover on June 20, 2003, at 20:05:48
In reply to Lar, Re: Vitamins mineral for moods , posted by McPac on June 20, 2003, at 19:44:40
> Make sure you add selenium, to a total of at least 200 mcg/day (it should be in the multi, too).
>
> >>>>>>>>>Lar, another poster here mentioned recently that "more than 200 mg/day of selenium is not good".......is there a daily limit?350 micrograms/day is the suggested long-term UL.
> If you can't tolerate ADs, I'd urge you to give SJW a try. It has a very low side-effect profile, comparable to placebo itself. Some people get digestive disturbance or headache, but those are transient side effects, easily treated with common remedies.
>
> Despite persistent reporting that SJW is effective only for mild to moderate depression, that simply is not true.Initial HAM-D scores of 25 or 26 are definitely severe depression.
Pharmacopsychiatry. 1997 Sep;30 Suppl 2:81-5.
Efficacy and tolerability of St. John's wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10.
Vorbach EU, Arnoldt KH, Hubner WD.
Department of Psychiatry and Psychotherapy, Ev. Krankenhaus Elisabethenstift, Darmstadt, Germany.
The special extract of St. John's wort, LI 160, exhibited a superior antidepressant efficacy compared to placebo in several controlled trials. Two further trials demonstrated a similar reduction of depressive symptomatology under LI 160 compared to tricyclics. All these trials were performed in mildly to moderately depressed patients. The present investigation was a randomized, controlled, multicentre, 6-week trial comparing 1800 mg LI 160/die to 150 mg imipramine/die in severely depressed patients according to ICD-10. The main efficacy parameter, a reduction of the total score of the Hamilton Depression Scale, proved both treatment regimens very effective at the end of the 6 week treatment period (mean values 25.3 to 14.5 in the LI 160 group and 26.1 to 13.6 in the imipramine group), but not statistically equivalent within a a-priori defined 25% interval of deviation. The analysis of subgroups with more than a 33% and 50% reduction of the HAMD total score justified the assumption of equivalence within a 25% deviation interval. This view was also supported by the global efficacy ratings from patients and investigators. Regarding adverse events, the nonrejection of the nonequivalence hypothesis denotes a superiority of the herbal antidepressant. These main result indicate that LI 160 might be a treatment alternative to the synthetic tricyclic antidepressant imipramine in the majority of severe forms of depressions. However, more studies of this type must be performed before a stronger recommendation can be made.
> >>>>>>>>>Geez, that's what I ALWAYS heard. I never thought it could be of use to me since I knew I needed something POWERFUL for severe depression. But now I'm wondering one other thing---anybody ever get relief from SJW for SEVERE ocd? You said take a higher dose for severe depression, could taking a higher dose for ocd possibly do anything? Does it have the effect of raising serotonin? (I know that some say that the serotonin thing isn't as important as is widely stated, but from everything I've read it does seem to say that the serotonin thing is what helps ocd...I don't know what to really believe, though the meds that supposedly work via mainly affecting serotonin are what has always worked for me, though again, I'm not really sure WHY it works I just know what DOES work). So, could SEVERE ocd possibly be helped by LARGER doses of SJW, like you are saying the higher doses for severe depression can work?It's possible, sure. There is preliminary evidence of effectiveness in OCD.
J Clin Psychiatry. 2000 Aug;61(8):575-8.
An open-label trial of St. John's Wort (Hypericum perforatum) in obsessive-compulsive disorder.
Taylor LH, Kobak KA.
Dean Foundation for Health Research and Education, Middleton, WI 53562, USA.
BACKGROUND: Recent interest in and evidence for the efficacy of St. John's wort (Hypericum perforatum) for the treatment of mild-to-moderate depression has led to speculation about its efficacy in other disorders. Hypericum's mechanism of action is postulated to be via inhibition of the synaptosomal uptake of serotonin. As such, there is a suggestion that Hypericum may be effective for obsessive-compulsive disorder (OCD). METHOD: Twelve subjects were evaluated with a primary DSM-IV diagnosis of OCD of at least 12 months' duration. Treatment lasted for 12 weeks, with a fixed dose of 450 mg of 0.3% hypericin (a psychoactive compound in Hypericum) twice daily (extended-release formulation). Weekly evaluations were conducted with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Patient Global Impressions of Improvement Scale, and the Clinical Global Impressions of Improvement scale (CGI) and monthly evaluation with the Hamilton Rating Scale for Depression. RESULTS: A significant change from baseline to endpoint was found, with a mean Y-BOCS change of 7.4 points (p = .001). Significant change occurred at 1 week (p = .020) and continued to increase throughout the trial. At endpoint, 5 (42%) of 12 were rated "much" or "very much improved" on the clinician-rated CGI, 6 (50%) were "minimally improved," and 1 (8%) had "no change." The most common side effects reported were diarrhea (N = 3) and restless sleep (N = 2). CONCLUSION: Significant improvement was found with Hypericum, with a drop-in Y-BOCS score similar to that found in clinical trials. The fact that a significant change was found as early as 1 week into treatment suggests a possible initial placebo response, although improvement grew larger over time. Results warrant a placebo-controlled study of Hypericum in OCD.
>
> You need to match the dose to the symptoms, just as you would with any other antidepressant. There is no known overdose level of SJW (I'm not suggesting you swallow a whole bottle), and it is quite safe to go up to 1800 or more mg/day. Titrate the dose upwards until either remission of symptoms or persistent adverse effects occur. Just watch your sun exposure, as some people find they are more prone to sunburn. However, B-vitamins reduce sunburn tendency, so you may find no such adverse effect.
>
> >>>>>>>>>>>Lar, just wanted to mention that I always try to read all of your posts. They are so informative and insightful. I always feel like I should pay you something for your advice though. You sure give better info than any doctor I ever paid a fortune to (and they never seemed to know much or do SQUAT for it, lol!)I'm just an opinionated geek.... ;-)
> p.s. I return to Pfeiffer next week! Looking forward to it. I'll be getting retested when I'm there also. It'll be interesting to compare my before/after test results (it's been 6 months on their supplement plan)...will have to see, among other things, if my very high histamine levels have come down. Take care Lar!!!!!
I'll be interested to hear how it goes......I'll be on the road for the next six weeks, though.
Take care, bud.
Lar
poster:Larry Hoover
thread:234747
URL: http://www.dr-bob.org/babble/20030619/msgs/235584.html