read only cites the paper I read below. It is still possible but I think
it's likely at placebo rates. The two case studies below are explained
by the cases being off their medication so it was relapse of the
'illness' that happened concurrently but wasn't cause by SJW use.
This paper is a systematic review. Here's a short snip from the paper to
understand what these are.
"
To prepare this review, electronic searches were conducted in nine
databases, including AMED, CANCERLIT, CINAHL, CISCOM, the Cochrane
Library, EMBASE, HerbMed, International Pharmaceutical Abstracts,
MEDLINE, and NAPRALERT. Search terms included the common names,
scientific names, and all listed synonyms for St. John's wort. Manual
searches were conducted in 20 additional journals (not indexed in common
databases) and in bibliographies from 50 selected secondary references.
No restrictions were placed on languages or on quality of publications.
"
By quality I think they mean they didn't only include randomised
controlled trials.
Harmmerness, P. 2003, St. John's Wort: A Systematic Review of Adverse
Effects and Drug Interactions for the Consultation Psychiatrist,
Psychosomatics 44:271-282,
http://psy.psychiatryonline.org/cgi/content/full/44/4/271
It's a long paper but pretty much covers everything. There are a few
case studies on mania. That's to be expected with an antidepressant-type
medication. It doesn't seem like a common effect. The evidence on
psychosis is only the two case studies I read below. It seems a possible
but very,very improbable risk.
"
more recent proposal is that the activity of St. John's wort's is by
means of inhibition of serotonin, norepinephrine, and dopamine synaptic
reuptake.
"
It's not a man made medicine. It's a combination of a lot of chemicals
and there's variation in the product across manufacturers. It works one
three neurotransmitter systems according to the most recent hypothesis.
SSRIs only work on serotonin. The ones for treatment resistent
depression (SNRIs) work on norepinephrine. Most interestingly to me it
is guessed that SJW works on inhibiting dopamine uptake. Antipsychotics
reduce dopamine transmission. That's their supposed effect based on the
psychiatric view of neuroleptic treatment of schizophrenia. I'm going to
leave it there because I can only guess at this stage.
Certainly from this systematic review I'd say the use of the word "may"
in the about.com page on SJW is at the 0./01% risk factor end rather
than the 99.99% end. It's a risk not owrth mentioning in mental health
public information.
A side effect I experience is needing to go for a piss a lot. Seems one
study has noted this side effect.
"
Frequent urination was reported in 27% of the patients taking 900–1500
mg/day of St. John's wort for 8 weeks versus 11% of the patients taking
placebo and 21% of the patients taking sertraline.
"
I've already started to experience this which is strange but not
impossible. I also get a specific effect which might have been mentioned
in this paper but I don't know the medical term for it. I call it bone
tingliness. It's the feeling of striking your funny bone but every bone
becomes like it. It rememnber how it felt after I took 40 300mg pills in
one go to see what would happened. I was buzzing happy for about a week
but if I stumbled into anything it really hurt and the pain was hone
pain. It's not a pleasant effect but I'm not to worried about side
effects. I tolerated a lot when I was on a double dose antipsychotics
and mood stabilisers. (700mg of queatpine and 3000mg of valporate plus
225mg venlaflaxine, 10mg propananol and 50mcg if thyroxine).
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