[marvin_pa]

I've seen a number of posts where people mentioned SJW with respect to despression/anxiety & whether/how well it worked for them.

2 questions for folks with any experience:

• For those for whom it worked, how well did it do & in what ways did it seem to help?
• For those for whom it didn't, what were the problems?

I tried it yesterday for the first time, as much as anything as an act of desperation before calling in the bigger guns. I really didn't expect much of it, but to my surprise, it did seem to help, taking quite an edge off my mood & doing so within a couple of hours of taking it.

Right now, I'm playing things by ear - seeing if it continues to help & whether it seems to cause any alternate issues. I am aware of one possible bad thing - reading up on SJW's list of interactions, it apparently can reduce the effectiveness of esomeprazole magnesium (Nexium), which I've been taking for GERD. Another thing to watch, but for right now, I'll take the much improved mood & clarity of thought.

Just trying to find out more at this point - I realize that this (especially the possible interactions) is something I probably at least need to talk with my regular doc about.

[GrayNess]

I don't have any personal experience with it, however, I do have academic experience from university (course in medical pharmacology). If you do use it, then do note that there are many possible interactions and these interactions can be with medications that at a superficial level seem to have no relation to St. john's Wort (i.e. certain immunosupresants).

However, beyond outlining what the possible interactions are, I don't have any personal experience with it.

[marvin_pa]

Originally Posted by GrayNess

I don't have any personal experience with it, however, I do have academic experience from university (course in medical pharmacology). If you do use it, then do note that there are many possible interactions and these interactions can be with medications that at a superficial level seem to have no relation to St. john's Wort (i.e. certain immunosupresants).

However, beyond outlining what the possible interactions are, I don't have any personal experience with it.

Thanks GreyNess - Yes, from my digging earlier, SJW has a pretty lengthy list of interactions - currently, the esomeprazole magnesium is the only medication I use on a regular basis. (Interestingly, that same digging revealed some reports that the esomeprazole itself may increase susceptibility to depression, which is something I previously had no idea about - however, I've been dealing with the depression for much longer than the esomeprazole, so it is unlikely to be a primary cause in my case.)

[paddym22]

Marvin

Do you know if one can take it whilst also taking anti depressants as an adjunct if the ADs are not as effective as they should be?

Just wondering if you may know this

Thanks

Paddy

[marvin_pa]

Originally Posted by paddym22

Marvin

Do you know if one can take it whilst also taking anti depressants as an adjunct if the ADs are not as effective as they should be?

Just wondering if you may know this

Thanks

Paddy

I've no personal experience, so I can't say that I know, but anti depressants meds were shown on the list of things that could become less effective if SJW was taken at the same time, along with a comment that when combined with certain antidepressants, it may also increase side effects such as nausea, anxiety, headache, and confusion.

Here's one of the pages where I found info -> http://nccam.nih.gov/health/stjohnsw...depression.htm

[deliquesce]

St John's Wort has been shown to be more effective than placebo, and as effective as typical anti-depressants (SSRIs) for the treatment of mild to moderate depression only. It's efficacy hasn't been established for melancholic depression or more severe forms.

I am confused about why people would want to take SJW before trying an antidepressant, because they are both thought to work on the same chemicals in the brain (actually, SJW is thought to be less specific - it targets many different neurotransmitters, whereas the 'big guns' can be quite specific e.g., serotonin only). Furthermore, unless it is overseen by a therapeutic goods administration, it is likely that the levels of active ingredient vary from one brand to another, or even within brands. I understand it's a personal choice thing, but I've always been confused about why people think "herbs" are somehow more gentle than pharma-manufactured drugs. I think they have the potential to be a lot more dangerous.

Whilst I'm glad you're feeling better, marvin, I doubt your lift in mood was due to the effect of SJW. SJW typically takes 10-14 days to effectively block the serotonin, dopamine etc from being taken up again - not something that can have an appreciable difference within a few hours!! Although I guess it is possible that the particular concoction you are taking doesn't only rely on only the herb as its active ingredient.

I'd encourage you to talk to your regular Doc about it, especially given the possible interactions you've already mentioned.

[Amazonmom]

I took it when I was depressed in college. It made me hyperactive and talk way too much, and the thoughts were racing through my head so fast I could barely keep a conversation going. I paced and practically vibrated. I stopped taking it because those effects were freaking me out. My friends told me it looked like I was just having a really good day every day!

I didn't know about the bipolar then. The mood switch into hypomania was less than a day after starting SJW, and ended after I stopped taking it.

[Rapunzel]

I started using SJW when I was severely depressed, and hadn't learned to speak up for myself and ask for what I needed. Although I had a lifetime history of depression, I generally kept it quiet, and had been in therapy several times and nobody ever suggested meds. I read about SJW online, and decided to try it. I have always preferred taking it in tea form, and was already used to using herbal tea for relaxation and sleep.

SJW worked for me, and much faster than I thought it would. It was within a day or two, I think. I remember the clouds clearing out and feeling much better than I ever had except for maybe a day or two at a time here and there. I had never not been depressed.

There was one side effect. After starting SJW, the other herbs that I took for relaxation were more powerful, and knocked me out. After a few years, I must have adapted, as my other herbs work normally now.

SJW was so good that I kept taking more and more of it. I got up to 3000-4000 mg/day, and had a hypomanic episode. Stopped taking SJW, and crashed. I was up and down for several months until I learned to be consistent and take my herbs appropriately. My psychologist demanded that I see a doctor about getting antidepressants, and I refused because SJW was working, I was doing the things I never thought I could before. I didn't want to give up something that worked and let doctors start experimenting on me, and I didn't want to give up the control of managing my own meds.

Sometimes I go off of my SJW in the summer, though, because I don't think I should need it when I have sunlight, and because i have less desire for warm drinks. I've been mostly off of it this month and I'm relapsing.

[marvin_pa]

Thanks for everyone's replies/comments. I appreciate any insight anybody may bring - good, or bad - I'm not advocating SJW as such, but I am curious what other people's experiences have been.

Deliquesce, the reason I tried SJW first, was not because of any particular preference for/against anti-depressant meds - it was primarily a case of it being readily available and a path of lesser resistance than my insurance is likely to be. That it appeared to make a difference for me & so quickly was largely was prompted my post - everything I'd seen led me not to expect anything to make much of a notable difference in less than at best a number of days. I remain highly wary of drawing any real conclusions, but each time I have taken the SJW, there has been a corresponding (and quite noticable to me) lift in my mood/outlook within a few hours. Still depressed, but it's a little more manageable. 0.3% hypericum is the only listed active ingredient for each 300mg tab, but I do know that may be moot with anything that's in the category of a dietary supplement.

[Amazonmom]

The whole reason I tried SJW was the fact that my parents would have found out about antidepressants when the insurance statements came. I couldn't afford to pay for care out of pocket so SJW was an experiment!

There has got to be an affordable way for college students to get mental healthcare without others finding out... I don't know about elsewhere but in the US it STINKS.

[deliquesce]

guh. i'm sorry guys - i totally forget to factor in the weird insurance thingy that goes on in the US. i don't really understand it, but it sounds really complicated and also pretty big brother-ish. i saw a psychiatrist for 2 years before i told my parents - and the only reason i told them was because my sister was going through psychosis and they refused to believe it was happening & deal with it. but the point is that i was able to keep it secret, which was so so so important for me. i have no idea what i would've done if things were tracked like that in australia.

eta: prior to seeing my psychiatrist i was able to access free therapy through uni services. i saw about 6 psychologists, all of whom eventually suggested i see a pdoc. i was so resistant to that idea but eventually i caved in when one of my lecturers noticed i was completely out of whack to the student he'd known the previous semester, and he shooed me off that way also .

SJW is used quite extensively in Europe and I think it's actually prescribed on the continent by Drs for mild/moderate depression. It's taken over-the-counter in the Uk. Not sure about US although I believe that it's rising in popularity. It does have quite a few interactions, the most common one being that it makes oral contraceptives less effective. Here's a list from gpnotebook.com:
"The CSM has advised that St John's Wort should not be used with:

• indinavir
• warfarin
• cyclosporin
• oral contraceptives
• theophylline
• digoxin

Although there is no direct evidence, it is likely that clinically important interactions may occur with:

• other HIV protease inhibitors (saquinavir, nelfinavir ritonavir)
• HIV non-nucleoside reverse transcriptase inhibitors (nevirapine, efavirnez)
• anticonvulsants (phenobarbitone, phenytoin, carbamazepine)

Additionally St John's Wort:

• may interact with selective serotonin reuptake inhibitors
• may have pharmacodynamic interactions with the triptans used to treat migraine"

It is very important not to take with other antidepressants or migraine drugs (triptans) because it can lead to Serotonin Syndrome.

Originally Posted by marvin_pa

2 questions for folks with any experience:

• For those for whom it worked, how well did it do & in what ways did it seem to help?
• For those for whom it didn't, what were the problems?

I did take SJW for a few months (I really didnt want to have to go to my GP and admit I was depressed) and, because it's OTC, you need to watch the dosage because there is a huge variation in the amounts available. Personally I didnt find it helped at all (though neither have any of the 8 antidepressants I've tried!), but I know people who found it did help, but they had mild depression.

Originally Posted by marvin_pa

I tried it yesterday for the first time, as much as anything as an act of desperation before calling in the bigger guns. I really didn't expect much of it, but to my surprise, it did seem to help, taking quite an edge off my mood & doing so within a couple of hours of taking it.

I would question such an immediate improvement as possible placebo effect (although who cares what causes it as long as you feel better eh?! lol)

Personally, I think it is safer (because dosages are regulated and interactions are avoided by your prescriber) to go to your Dr and see what they suggest. If you would rather go down the complementary med route, studies show that 1g EPA (found in omega 3 fish oil - check the bottle to ensure that there is enough EPA as again amounts do vary) daily can help with depression. Interactions are rare/non-existent and the only side effects I've read about are fishy-tasting burps and a bit of nausea. I'm not a dr though so please do do your own research/see your dr.

Hope that helps!

*Willow*

Originally Posted by paddym22

Do you know if one can take it whilst also taking anti depressants as an adjunct if the ADs are not as effective as they should be?

Please, please, please do not take SJW if you are on antidepressants. They work in a similar way and could lead to a dangerous level of serotonin in the brain (serotonin syndrome)

http://en.wikipedia.org/wiki/Serotonin_syndrome
"Serotonin syndrome is a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, overdose of particular drugs, or the recreational use of certain drugs...
Symptom onset is usually rapid, often occurring within minutes. Serotonin syndrome encompasses a wide range of clinical findings. Mild symptoms may only consist of increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor or twitching), as well as overresponsive reflexes.[1] Moderate intoxication includes additional abnormalities such as hyperactive bowel sounds, high blood pressure and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication. The overactive reflexes and clonus in moderate cases may be greater in the lower limbs than in the upper limbs. Mental status changes include hypervigilance and agitation.[1] Severe symptoms include severe increases in heart rate and blood pressure that may lead to shock. Temperature may rise to above 41.1 °C (106.0 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation; these effects usually arise as a consequence of hyperthermia.[1][3]
The symptoms are often described as a clinical triad of abnormalities:[1][5]

• Cognitive effects: mental confusion, hypomania, hallucinations, agitation, headache, coma
• Autonomic effects: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea.
• Somatic effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor."

Please go and see your doctor about tweaking your meds; it's too dangerous to do it on your own. Drs are experienced at doing this and know how to combine ADs if necessary without you suffering from Serotonin Syndrome. Many people think that because they're flowers/complementary they're safe, but most of our drugs come from plants and most people wouldn't mess with their meds without medical advice.

*Willow*