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St John's Wort
Herbal remedy for anxiety and depression
- uses
- mechanism
- dose and half-life
- adverse drug reactions
- counter-indications and drug interactions
- metabolism and excretion
- dependency
Uses
- anxiety
- depression
Mechanism
- Extract of Hypercicum Perforatum - hyperforin and hypericin (flavinoids, tannins etc present as well)
- inhibits serotonin (5HT) reuptake as well as Dopamine (DA), Norepinephrine (NE)
- also thought to activate GABA and glutamate receptors
Dose and Half Life
Adverse Drug Reactions
common
- GI symptoms, dizziness, confusion, fatigue, sedation, photosensitivity
long term
Counter-Indications and Drug Interactions
- decreased effectiveness of oral contraceptives, serotonin syndrome when combined with other drugs that increase 5HT (SSRIs),
- induces cytochromes CYP3A4 and 2C9 liver enzymes that metabolize drugs
- may affect p-glycoprotein
- may interfere with dioxin
- erythromycin
- atorvastatin
- cyclosporin
- warfarin
- fluoxitine
- sumatripan
- oral contraceptives
Metabolism and Excretion