Monday, July 20, 2015

St. John’s Wort vs Prozac

Researchers at Adelaide University compared the reported adverse drug reactions to St. John’s wort, an herbal treatment for depression, with fluoxetine, a prescription antidepressant which includes Prozac.

It found both can cause serious side effects such as dangerous increases in body temperature and blood pressure. Both treatments also caused side effects such as anxiety, panic attacks, dizziness, vomiting, amnesia and aggression.

“There is a common belief that because something is natural and can be purchased from a health food shop without a prescription, it’s safe,” says researcher Claire Hoban.

“People need to start thinking of St. John’s wort, and other herbal medicines, as a drug and seek advice from a qualified healthcare practitioner to be sure they use it safely,” she says.

Between 2000 and 2013, there were 84 reports of adverse reactions to St. John’s wort and 447 to fluoxetine, [notes] the study published in Clinical and Experimental Pharmacology and Physiology.

Fewer people use St. John’s wort and adverse reactions for herbal medicines largely go unreported because they are not considered drugs, say Hoban.

There were more severe reactions to St. John’s wort, 11.9% of reports compared to 6.7% for Prozac.
The big concern is using St. John’s wort and prescription antidepressants together because this can lead to serotonin syndrome inducing gastrointestinal upsets, hemorrhage, confusion, inattention and even death, she said.

Senior lecturer in pharmacology Dr. Ian Musgrave says the real danger is that people can access St. John’s wort without a prescription so there is no control over the dosage or what drugs people are using it with.

“Most people taking St. John’s wort will not have any adverse reaction; however, those who do take it should tell their doctor and pharmacist,” says Dr. Musgrave.

My Take:
I frequently use St. John’s wort in my practice, but I use it for neuropathy, not depression. It is amazingly effective when used properly. However, it does interact with many medications, especially antidepressants, like Prozac.

Because antidepressants are so commonly taken in the U.S., I have had to substitute inositol for St. John’s wort more and more frequently the past few years.

One of the actions of St. John’s wort is to enhance phase I liver detoxification through the cytochrome P-450 pathway. That is the same pathway your body uses to remove many prescription drugs, like Coumadin (a blood thinner) and the proteases used to treat HIV/aids. The use of St. John’s wort with these medications can be life threatening.

Baring drug-herb interactions, I find side effects from St. John’s wort to be about 1%, not the 11.9% reported in this study. On the other hand, reported side effects from Prozac run about 33%, in my clinical experience.

The Bottom Line:
St. John’s wort is a very safe and effective herb when used properly. However, that use should be supervised by a nutritionist that is well versed in herbal remedies.

Source: July 1, 2015

No comments:

Post a Comment

Comments Await Approval Before Posting