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Doctors' Answers to "Frequently Asked Questions" - St. John's Wort
Answer: Wellbutrin is a stronger drug in general than St. John's Wort. St. John's is like a MAO inhibitor if you have ever tried them. Wellbutrin can help anxiety, just not a FDA indication. I'd try it first, then the St. John's wort. By the way, lots of patients need xanax and some antidepressant in agitated depression.
Answer: Wouldn't until you stop breast feeding. There is no data at all on the development of children exposed to these type of drugs.
St. John's Wort With Other Medications [posted 10/13/98]
Answer: Nothing obvious.
St. John's Wort [posted 8/6/98]
Answer: Shouldn't be a problem. The only obvious interaction is with certain foods - at least theoretically: chicken liver, pickled herring, yogurt, beer, wine (especially red, sherry and chianti), bananas, avocados, raisins, chocolate, sour cream, soy sauce. This is because St. John's Wort is a mild MAO inhibitor.
St. John's Wort and Excedrin [posted 8/4/98]
Answer: Probably, the only risks that are listed are foods such as red wines, sour cream, chicken liver, aged cheeses, bananas, soy sauce, chocolate, raisins, cold medication with decongestants, etc. Having said that I haven't had a patient with any food interaction on the medication. I think judicial use of the foods is ok, but watch decongestants (pseudofed and the like) more closely.
St. John's Wort and Other Medications [posted 7/30/98]
Answer: Shouldn't. St. John's Wort is a weak MAO inhibitor according to the drug researchers. There are foods that one is recommended to avoid. I usually tell my patients this list. However, I haven't seen any major reactions in the ER or with my patients so, I'm not sure how aggressive you need to be in avoiding the particular foods. They are: Chocolate, excessive caffeine, soy sauce, bananas, figs (canned), avocados, raisins, yogurt, sour cream, cheese(especially aged, cheddar, blud), beer, wine (especially red), chicken liver and pickled herring.
St. John's Wort
Answer: Hypericum is the name for the chemical derived from St. John's Wort. This is a perennial flower found in many gardens. The drug is usually dispensed in 300 mg pills and usually patients take 300 mg twice a day or 300 mg three times a day. Side effects tend to be minimal, but research on longer side effects is in progress. This drug takes about three weeks to work, but some find it works faster, and should not be taken with prescription antidepressants (lack of research behind this precaution).
St. John's Wort
Answer: I have some patients who think they are better and the side effects are clearly better. I don't
think it is as effective as the SRI class, but there may be patients for which it is superior, especially
in decreasing side effects. However, medical research is only in progress and I can't tell you the
side effects, metabolism, etc., since I really don't know. Keep tuned, but most drugs are affected
by the liver.