[mrsbloom42]

I am aware that it is unwise to combine the herbal remedy St John's Wort with most prescription meds this is usually due to the fact that some anti-depressants increase serotonin (or at least stop it from being re-absorbed) as does SJW.

However I am taking lofepramine (Gamanil) an older style tricyclic. The patient information leaflet says not to take with SJW as it may affect the way the tablets work.

Can anyone explain the exact reasons. Would it cause serotonin syndrome, or would it render the lofepramine ineffective ? what would the implications be ?

I hope I've made myself clear ! and hope someone can help ? Thanks !

[madisgram]

jme, i did that and i had an enormous down swing depression....one of the most intense i've ever experienced...it scared me to death... at the time i didn't know this might happen. now i don't take anything over the counter like herbals unless i ask my pdoc first...basically i know this isn't a good idea now.

[tarabug922]

SJW is a MAOI - monoamineoxidase inhibitor and can cause a serious interaction with SSRI's.

MAOI's work by blocking the enzyme monoamine oxidase which breaks down the neurotransmitters dopamine, serotonin, and norepinephrine (noradrenaline). MAOIs can be as effective as tricyclic antidepressants, although they can have a higher incidence of dangerous side effects (wikipedia)

Tricyclics block the reuptake of certain neurotransmitters such as norepinephrine (noradrenaline) and serotonin (Wikipedia)

SSRIs are said to work by preventing the reuptake of serotonin (Wikipedia)

So from what I can gather if you took both you would be creating an excess of certain neurotransmitters such as seroton, that couldn't then be broken down. They would essentially have nowhere to go.

Hope this helps,

Love and Hugs,
Tara