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• Dec 17, 2010
Avoid St. John's Wort if on Antidepressant - ciar
Learn how various health supplements may interact when taken with MAO-inhibitors, selective serotonin-reuptake inhibitors and tricyclic antidepressants.
If you are being treated for depression with antidepressants, it is worth knowing which health supplements are safe to take for combination treatment. Health supplements, whether herbal or natural remedies, can have side-effects and may be harmful when taken with some forms of antidepressant medication.
Which Health Supplements Interact With Selective Serotonin-Reuptake Inhibitors (SSRIs)?
Selective serotonin-reuptake inhibitors (SSRIs) are a class of antidepressants, which include citalopram, Prozac, fluvoxamine, paroxetine and sertraline. There are three health supplements recognised as potentially harmful when taken in conjunction with SSRIs:
• 5-HTP (5-hydroxytryptophan)
• SAMe (S-adenosylmethionine)
• St. John's Wort (Hypericum perforatum)
According to Bratman (2007), taking 5-HTP, SAMe or St. John's Wort in addition to SSRIs may result in serotonin levels becoming too high, known as serotonin syndrome. Requiring urgent medical attention, serotonin syndrome causes muscle twitching, high fever, confusion, anxiety and rapid heartbeat.
Supplements to Avoid With MAO-Inhibitors – Antidepressant Interactions
Another class of antidepressants, known as MAO-inhibitors (monoamine oxidase inhibitors), include furazolidone, isocarboxazid, phenelzine sulfate and tranylcypromine sulfate.
As with SSRIs, there are also certain supplements best avoided when on a course of MAO-inhibitors. Bratman (2007) highlights seven supplements causing potential harm, when combined with this class of antidepressants, to include the following:
• Ephedra – can rapidly produce severe, dangerous interaction
• Ginseng
• Green Tea – caffeine reacts badly with MAO-inhibitors
• SAMe
• 5-HTP
• Scotch Broom – contains high levels of tyramine
• St. John's Wort – raises serotonin levels, causing serotonin syndrome
Which Supplements Interact With Tricyclic Antidepressants?
Tricyclic antidepressants include: amitriptytline, amoxapine, clomipramine, desimpramine, doxepin, imipramine, noritriptyline, protriptyline and timipramine. There are four types of supplements which are believed to cause a potentially harmful reaction when combined with tricyclic antidepressants, including as follows:
• St. John's Wort
• Yohimbe
• 5-HTP
• SAMe
According to Bratman (2007), each of these four supplements can result in serotonin levels becoming too high. St. John's Wort is particularly unhelpful when combined with tricyclics, because it lowers blood levels of the medication and reduces its effectiveness.
• Selective Serotonin Reuptake Inhibitors
• Antidepressants and other Depression Medication
• Serotonin Syndrome Symptoms and Treatment
Supplements Safe to Take With Antidepressants
One form of health supplement which has been identified as safe and helpful to take with tricyclic antidepressants is co-enzyme Q10 (CoQ10). Bratman recognised that co-enzyme Q10 helps to prevent heart-related side effects which may occur in depression sufferers on this medication. Male patients taking the more modern SSRI class of antidepressants may benefit from taking ginkgo, while female patients may be helped by combining SSRIs with folate.
As highlighted above, certain types of health supplements cause potential harm, when combined with SSRIs, MAO inhibitors and tricyclic antidepressants. In particular, SAMe, 5-HTP and St. John's Wort are best avoided when your depression is being treated with antidepressant medications.
Source:
Bratman, S. Complementary & Alternative. London: Collins, 2007.
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