# random substance questions: 5-HTP and St Johns Wort...and kratom



## dragthewaters

I bought 5-HTP and St Johns Wort at the supermarket yesterday. Then I learned that you can get serotonin syndrome from taking them simultaneously. Should I use them in tandem by taking them on alternate days? Should I only use one and return the other? If so which one is better? How are they different from each other? Do you have to take them every day for them to work or can you take them only when having cyclic symptoms? Any experiences you guys can share about taking them? I have anxiety and some kind of mood disorder, possibly cyclothymia, and I do not ever want to go on traditional antidepressants or mood stabilizers for a variety of reasons.

Also this has nothing to do with the preceding paragraph, but I dont feel like making another thread. I read the opiates reddit group pretty often and found out about kratom, which is a traditional medicine that has similar effects to morphine but less severe, and is legal (for now). Just curious to hear PerC's perspective, has anyone tried it and what was it like? Also has anyone tried poppy seed tea and what was that like?


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## wolvent42

Have you heard of L-Tryptophan? Your body will not go over its normal production of serotonin with it. It appears safer than 5-htp.


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## dragthewaters

wolvent42 said:


> Have you heard of L-Tryptophan? Your body will not go over its normal production of serotonin with it. It appears safer than 5-htp.


Wouldn't that cause drowsiness? I think 5-htp is perfectly safe if taken as directed...like any other drug, you have to take many times the normal dose to get sick. I am just not sure how to use it in combination with St Johns Wort, or which one is "better."


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## SiFan

thismustbetheplace said:


> I bought 5-HTP and St Johns Wort at the supermarket yesterday. Then I learned that you can get serotonin syndrome from taking them simultaneously. Should I use them in tandem by taking them on alternate days? Should I only use one and return the other? If so which one is better? How are they different from each other? Do you have to take them every day for them to work or can you take them only when having cyclic symptoms? Any experiences you guys can share about taking them? I have anxiety and some kind of mood disorder, possibly cyclothymia, and I do not ever want to go on traditional antidepressants or mood stabilizers for a variety of reasons.
> 
> ....


Both 5-HTP and St. John's Wort are supported for treating depression. Probably, you would not want to combine them; partly due to worries of serotonin syndrom and partly concerns about conflicting actions which might eliminate benefits. So swapping back and forth day to day wouldn't be cool, either.

Suggest starting with 5-HTP for at least a few weeks because 5-HTP has fewer side effects. According to WebMD, research shows that taking 5-HTP by mouth might improve symptoms of depression. Several trials have found that daily doses over 2-4 weeks can improve symptoms of depression.

Not sure of dose to try for your situation. I've taken 5-HTP for years as a sleep aid before bedtime. A dose of 50mg or 100mg seems to work fine. (Only reason for taking 100mg is that it's the easier dose to find on the shelves.) According to Drugs.com ...

Recent clinical trials do not provide adequate dosing guidelines. Studies in depression have used 5-HTP 200 to 300 mg/day given in 3 to 4 divided doses to prevent possible nausea.

Maybe 50mg or 100mg twice a day would be a good start.

I do not have much experience with St. John's Wort.

other refs ...

Wiki: 5-HTP- https://en.wikipedia.org/wiki/5-Hydroxytryptophan 

Wiki: St. John's Wort- https://en.wikipedia.org/wiki/Hypericum_perforatum

Wiki: Tryptophan- https://en.wikipedia.org/wiki/Tryptophan

Kratom: A study- https://www.erowid.org/plants/kratom/kratom_journal3.shtml

Kratom extract tolerance- http://www.politiquessociales.net/kratom-extract-tolerance/


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## Tsaiireii

I am biased as a pharmacy student, but herbal supplements are not regulated as drugs are, and clinical data is inconsistent and a lot of trials are poorly designed. You mention that it's safe if used as directed... but are you getting directed information from a professional? If not, I'd advise looking around for a healthcare professional that has experience w/ alternative medicine. Anecdotes from the internet do not guarantee safety.

They can cause serotonin syndrome; most drugs that affect mood like SSRIs have this risk. You have to be careful with St. John's Wort and tyramine-rich foods as it can cause hypertensive crisis, which is life-threatening (part of the serotonin syndrome). It also has a ton of drug interactions due to CYP450 enzymes, if you're taking other meds.

ETA: drug-drug interaction that may or may not be relevant for anyone reading: oral contraceptives. St. John's Wort is a CYP3A4 inducer, which basically means that it increases the metabolism of other CYP drugs. Your contraceptive will be less effective and breakthrough bleeding will increase.


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## dragthewaters

SiFan said:


> Both 5-HTP and St. John's Wort are supported for treating depression. Probably, you would not want to combine them; partly due to worries of serotonin syndrom and partly concerns about conflicting actions which might eliminate benefits. So swapping back and forth day to day wouldn't be cool, either.
> 
> Suggest starting with 5-HTP for at least a few weeks because 5-HTP has fewer side effects. According to WebMD, research shows that taking 5-HTP by mouth might improve symptoms of depression. Several trials have found that daily doses over 2-4 weeks can improve symptoms of depression.
> 
> Not sure of dose to try for your situation. I've taken 5-HTP for years as a sleep aid before bedtime. A dose of 50mg or 100mg seems to work fine. (Only reason for taking 100mg is that it's the easier dose to find on the shelves.) According to Drugs.com ...
> 
> Recent clinical trials do not provide adequate dosing guidelines. Studies in depression have used 5-HTP 200 to 300 mg/day given in 3 to 4 divided doses to prevent possible nausea.
> 
> Maybe 50mg or 100mg twice a day would be a good start.
> 
> I do not have much experience with St. John's Wort.
> 
> other refs ...
> 
> Wiki: 5-HTP- https://en.wikipedia.org/wiki/5-Hydroxytryptophan
> 
> Wiki: St. John's Wort- https://en.wikipedia.org/wiki/Hypericum_perforatum
> 
> Wiki: Tryptophan- https://en.wikipedia.org/wiki/Tryptophan
> 
> Kratom: A study- https://www.erowid.org/plants/kratom/kratom_journal3.shtml
> 
> Kratom extract tolerance- http://www.politiquessociales.net/kratom-extract-tolerance/


It says how much to take on the bottle. With 5 HTP I am afraid of getting that rare blood disorder though. L -tryptophan has an even higher risk of that disorder and has been linked to 37 deaths from it. But St Johns Wort interacts with other drugs (not that I take any) and makes them ineffective, and can also make you infertile (only temporarily though I think).

I know about erowid and all that and theres a lot of info about kratom online, was just curious to see if anyone on here tried it.


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## dragthewaters

Tsaiireii said:


> I am biased as a pharmacy student, but herbal supplements are not regulated as drugs are, and clinical data is inconsistent and a lot of trials are poorly designed. You mention that it's safe if used as directed... but are you getting directed information from a professional? If not, I'd advise looking around for a healthcare professional that has experience w/ alternative medicine. Anecdotes from the internet do not guarantee safety.
> 
> They can cause serotonin syndrome; most drugs that affect mood like SSRIs have this risk. You have to be careful with St. John's Wort and tyramine-rich foods as it can cause hypertensive crisis, which is life-threatening (part of the serotonin syndrome). It also has a ton of drug interactions due to CYP450 enzymes, if you're taking other meds.
> 
> ETA: drug-drug interaction that may or may not be relevant for anyone reading: oral contraceptives. St. John's Wort is a CYP3A4 inducer, which basically means that it increases the metabolism of other CYP drugs. Your contraceptive will be less effective and breakthrough bleeding will increase.


But I cant ask a "health professional" because as you say, theyre biased. Pretty much every psychiatrist has tried to bully me into taking antidepressants. If I could actually trust them to give me an informed opinion...but they are all shills for the pharmaceutical industry, which has a long history of not really giving a fuck about the people it treats, if that gets in the way of profit.

How regulated are psychiatric medications really? My high school best friend went on Prozac and became psychotic and intolerable to be atound. My dad went on Effexor and some other thing a few months ago. He has gained 50 pounds in 4 months, and has high blood pressure and has to take blood thinners which cause edema, when he NEVER had those problems before. I dont see him living another 10 years. Fuck. That. Shit. I would literally rather shoot black tar heroin than put that toxic shit into my body.


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## C3bBb

thismustbetheplace said:


> But I cant ask a "health professional" because as you say, theyre biased. Pretty much every psychiatrist has tried to bully me into taking antidepressants. If I could actually trust them to give me an informed opinion...but they are all shills for the pharmaceutical industry, which has a long history of not really giving a fuck about the people it treats, if that gets in the way of profit.
> 
> How regulated are psychiatric medications really? My high school best friend went on Prozac and became psychotic and intolerable to be atound. My dad went on Effexor and some other thing a few months ago. He has gained 50 pounds in 4 months, and has high blood pressure and has to take blood thinners which cause edema, when he NEVER had those problems before. I dont see him living another 10 years. Fuck. That. Shit. I would literally rather shoot black tar heroin than put that toxic shit into my body.


There are a few things in this post that I take issue with. First, it's important to understand that pharmaceutical companies are not out to get anyone for the sake of profit. It doesn't make any sense business-wise for a drug that's shown to be harmful to the majority of the population to be released. No one would take them because they'd be harmful, right? And even if the drug showed to be harmful to a significant portion of the population, chances are it wouldn't even pass through the 4 rigorous clinical trial stages. This is a significant difference between your prescription drugs and your alternative medicines. Alternative medicines such as herbal supplements *do not *have to undergo clinical trials, nor do they need FDA approval prior to being marketed. This means that they can advertise whatever positive effect they may have and not need formal scientific confirmation in doing so, unlike your prescription drugs.

Secondly, it is markedly unfair to call health professionals "shills for the pharmaceutical industry." Health professionals do not receive any more compensation for prescribing tea and rest vs. prescribing NSAIDs or antibiotics. It's simply a matter of what's commonly scientifically accepted, and what's not. If you have strep throat, it's scientifically accepted and recommended to prescribe an antibiotic to get rid of the infection. There's no reward to prescribing anything, but also due in part to societal pressures and our constant need to have things resolved ASAP, doctors are forced to find quick fixes for people who need them. In other words, health care professionals are not all to blame for our obsession with drug prescriptions. 

When you take an SSRI it is a common SIDE effect to experience weight gain. SOME, not all, patients who have been prescribed them have also gained weight as well. I work at a family medicine clinic, and I see a lot of different spectrums of people. Some react really well to certain SSRI's and some respond better to others. The field of psychiatry is complex because mental pain in itself is complex and it often requires a "mix and matching" of different drugs before we find out the right combination of drugs for a given situation. I would recommend looking into Viibryd which is an SSRI, but has not been shown to have weight gain as a common side effect.


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## dragthewaters

Senshu_Ben_Gone said:


> There are a few things in this post that I take issue with. First, it's important to understand that pharmaceutical companies are not out to get anyone for the sake of profit. It doesn't make any sense business-wise for a drug that's shown to be harmful to the majority of the population to be released. No one would take them because they'd be harmful, right? And even if the drug showed to be harmful to a significant portion of the population, chances are it wouldn't even pass through the 4 rigorous clinical trial stages. This is a significant difference between your prescription drugs and your alternative medicines. Alternative medicines such as herbal supplements *do not *have to undergo clinical trials, nor do they need FDA approval prior to being marketed. This means that they can advertise whatever positive effect they may have and not need formal scientific confirmation in doing so, unlike your prescription drugs.


Of course it makes sense. I work as a molecular biologist. I know how ridiculously expensive and time consuming drug development is. Dony forget that the pharmaceutical industry refuses to seriously invest in development of new antibiotics, or in cures for diseases that primarily affect the Third World, because they arent profitable. Eli Lilly has been sued so many times by people adversely affected by Prozac, that they have a 1000 page playbook to give their lawyers whenever another case comes up. There have been hundreds of suicides and even homicides linked to Prozac. Yet it's still being prescribed.

Plus they totally do profit from it. If you are a pharmacist Im sure youre familiar with patients being prescribed 3 or 4 other drugs to counteract the side effects of the previous ones.

Fact: most psychiatrists do downplay the negative side effects of these drugs. My fiance was prescribed Risperdal for atypical depression and looked up the side effects online, then came to his doctor with concerns. The doctor literally said "dont believe what you read online." Guess what, he took it and gained 50 pounds in like 6 months, and even then his doctor tried to bully him into staying on it. More than one therapist has literally laughed in my face when I brought up the side effects. Most people trust doctors by default and most doctors dont even mention the side effects, you have to look them up yourself. Also many people give up and take these drugs because there are no better options.



> Secondly, it is markedly unfair to call health professionals "shills for the pharmaceutical industry." Health professionals do not receive any more compensation for prescribing tea and rest vs. prescribing NSAIDs or antibiotics. It's simply a matter of what's commonly scientifically accepted, and what's not. If you have strep throat, it's scientifically accepted and recommended to prescribe an antibiotic to get rid of the infection. There's no reward to prescribing anything, but also due in part to societal pressures and our constant need to have things resolved ASAP, doctors are forced to find quick fixes for people who need them. In other words, health care professionals are not all to blame for our obsession with drug prescriptions.


Does your doctor have ties to big pharma? How you'll be able to find out - CBS News

Doctors Often Receive Payments From Drug Companies : NPR

Need I go on? 



> When you take an SSRI it is a common SIDE effect to experience weight gain. SOME, not all, patients who have been prescribed them have also gained weight as well. I work at a family medicine clinic, and I see a lot of different spectrums of people. Some react really well to certain SSRI's and some respond better to others. The field of psychiatry is complex because mental pain in itself is complex and it often requires a "mix and matching" of different drugs before we find out the right combination of drugs for a given situation. I would recommend looking into Viibryd which is an SSRI, but has not been shown to have weight gain as a common side effect.


Well tell his doctors that...he is on Medicaid in a government facility for mentally ill and disabled adults. If he goes off his medication they will kick him out of the facility and he will be homeless. My mom's theory is they are trying to kill him so they dont have to pay anymore. I cant say anything theyve done so far contradicts that theory.


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## C3bBb

thismustbetheplace said:


> Of course it makes sense. I work as a molecular biologist. I know how ridiculously expensive and time consuming drug development is. Dony forget that the pharmaceutical industry refuses to seriously invest in development of new antibiotics, or in cures for diseases that primarily affect the Third World, because they arent profitable. Eli Lilly has been sued so many times by people adversely affected by Prozac, that they have a 1000 page playbook to give their lawyers whenever another case comes up. There have been hundreds of suicides and even homicides linked to Prozac. Yet it's still being prescribed.
> 
> Plus they totally do profit from it. If you are a pharmacist Im sure youre familiar with patients being prescribed 3 or 4 other drugs to counteract the side effects of the previous ones.
> 
> Fact: most psychiatrists do downplay the negative side effects of these drugs. My fiance was prescribed Risperdal for atypical depression and looked up the side effects online, then came to his doctor with concerns. The doctor literally said "dont believe what you read online." Guess what, he took it and gained 50 pounds in like 6 months, and even then his doctor tried to bully him into staying on it. More than one therapist has literally laughed in my face when I brought up the side effects. Most people trust doctors by default and most doctors dont even mention the side effects, you have to look them up yourself. Also many people give up and take these drugs because there are no better options.
> 
> 
> 
> Does your doctor have ties to big pharma? How you'll be able to find out - CBS News
> 
> Doctors Often Receive Payments From Drug Companies : NPR
> 
> Need I go on?
> 
> 
> 
> Well tell his doctors that...he is on Medicaid in a government facility for mentally ill and disabled adults. If he goes off his medication they will kick him out of the facility and he will be homeless. My mom's theory is they are trying to kill him so they dont have to pay anymore. I cant say anything theyve done so far contradicts that theory.



Having "ties" to drug companies is different from being a shill for the company. Doctors may be influenced by other companies to encourage a product, but they still have free choice over what they want to prescribe and to whom they want to prescribe. As I said, there's no real benefit for doctors to prescribe these medicines, but they make these decisions based on verifiable scientific evidence as well as public pressure. Of course pharmacy companies will profit and that is their goal, but their profit is based on the performance of their products, otherwise they would go bankrupt. Designing a drug that works is a win-win for both the patient and the drug company.

And I have read articles on big pharma in the past and admit that there's been an increasing distrust in doctors and drug companies that have influenced people's gradual turn towards alternative medicine. However, there's also a lot of misinformation and exaggeration being thrown and publicized in the media which is generally what the media tends to do if the realm of politics has taught us anything. Some of these same people who are anti-traditional medicine and refuse to allow certain vaccines their children for fear of causing autism (a fear that has long since been proclaimed as patently untrue and the original article that claimed this has been retracted) end up being one of the sole factors behind how diseases that have traditionally been quelled since the vaccinations' inception to begin re-emerging with tuberculosis being a prime example.

Not all doctors are the same. I will say that some who turn away from patients and only look towards providing the most care to the most people will sacrifice some quality in the process. However, doctors I have worked with have almost always talked about side effects before prescribing medications. I think the psychiatrists you have talked to are not a good representation of how doctors should practice medicine. Doctors are not in the business of trying to withhold information to shove pills down your throat. It serves really no purpose for them other than to get patients out the door quicker, and in that regard, it certainly is a moral dilemma I admit. But this aside, my own speculation for why might not tell you of all the side effects is if they did, most patients would be too freaked out to even take the medicine, a medicine whose chance to help treat your illness outweighs the risks involved. Even the most benign medicines can cause death, but could you honestly expect to die after taking one aspirin pill?

Medicaid is a whole different realm and I will admit trying to treat older people has been increasingly a challenge with all the governmental regulations being set in place. I can't speak for your dad, but I hope that they can eventually find a feasible method of treatment that will produce better results whether that's through a different medication or a different way of tackling the issue.


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## dragthewaters

Senshu_Ben_Gone said:


> Having "ties" to drug companies is different from being a shill for the company. Doctors may be influenced by other companies to encourage a product, but they still have free choice over what they want to prescribe and to whom they want to prescribe. As I said, there's no real benefit for doctors to prescribe these medicines, but they make these decisions based on verifiable scientific evidence as well as public pressure. Of course pharmacy companies will profit and that is their goal, but their profit is based on the performance of their products, otherwise they would go bankrupt. Designing a drug that works is a win-win for both the patient and the drug company.


You honestly think that being paid to promote a product isnt going to influence what ends up being prescribed? Honestly?

They wont go bankrupt if there are no better options on the market, and there is always a supply of people who need these drugs so badly that they will put up with the side effects.



> And I have read articles on big pharma in the past and admit that there's been an increasing distrust in doctors and drug companies that have influenced people's gradual turn towards alternative medicine. However, there's also a lot of misinformation and exaggeration being thrown and publicized in the media which is generally what the media tends to do if the realm of politics has taught us anything. Some of these same people who are anti-traditional medicine and refuse to allow certain vaccines their children for fear of causing autism (a fear that has long since been proclaimed as patently untrue and the original article that claimed this has been retracted) end up being one of the sole factors behind how diseases that have traditionally been quelled since the vaccinations' inception to begin re-emerging with tuberculosis being a prime example.


Actually this stuff has not been covered that much in the media. Most people have no idea how dangerous Prozac can be for example, or that benzo withdrawal can kill you, even people who are on these drugs.

These side effects are well documented. Please do not try to discredit what Im saying by comparing it to anti-vaxxers. Those things have nothing to do with each other.



> Not all doctors are the same. I will say that some who turn away from patients and only look towards providing the most care to the most people will sacrifice some quality in the process. However, doctors I have worked with have almost always talked about side effects before prescribing medications. I think the psychiatrists you have talked to are not a good representation of how doctors should practice medicine. Doctors are not in the business of trying to withhold information to shove pills down your throat. It serves really no purpose for them other than to get patients out the door quicker, and in that regard, it certainly is a moral dilemma I admit. But this aside, my own speculation for why might not tell you of all the side effects is if they did, most patients would be too freaked out to even take the medicine, a medicine whose chance to help treat your illness outweighs the risks involved. Even the most benign medicines can cause death, but could you honestly expect to die after taking one aspirin pill?


Thats gaslighting though. Telling someone that their concerns are unfounded because you think they will get "freaked out" for what you consider to be no good reason. And as you said, to get them out the door faster.

Literally every doctor that I or someone I know has been to for mental health issues, has acted this way.



> Medicaid is a whole different realm and I will admit trying to treat older people has been increasingly a challenge with all the governmental regulations being set in place. I can't speak for your dad, but I hope that they can eventually find a feasible method of treatment that will produce better results whether that's through a different medication or a different way of tackling the issue.


Medicaid is for the indigent. Medicare is for old people. Well you know what they say, a society is only as good as how it treats its weakest members.


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## C3bBb

thismustbetheplace said:


> You honestly think that being paid to promote a product isnt going to influence what ends up being prescribed? Honestly?
> 
> They wont go bankrupt if there are no better options on the market, and there is always a supply of people who need these drugs so badly that they will put up with the side effects.
> 
> 
> 
> Actually this stuff has not been covered that much in the media. Most people have no idea how dangerous Prozac can be for example, or that benzo withdrawal can kill you, even people who are on these drugs.
> 
> These side effects are well documented. Please do not try to discredit what Im saying by comparing it to anti-vaxxers. Those things have nothing to do with each other.
> 
> 
> 
> Thats gaslighting though. Telling someone that their concerns are unfounded because you think they will get "freaked out" for what you consider to be no good reason. And as you said, to get them out the door faster.
> 
> Literally every doctor that I or someone I know has been to for mental health issues, has acted this way.
> 
> 
> 
> Medicaid is for the indigent. Medicare is for old people. Well you know what they say, a society is only as good as how it treats its weakest members.


I'm sure TV doctors might get a royalty check for showing up on a drug advertisement, but I know that typical practicing doctors are not paid to promote a product. This is against the law and a common misconception. Pharmaceutical reps can bring food or other gratuities that do not exceed a given amount to a doctor's office and verbally encourage them to prescribe the product through, but again, this is different from literally handing money to a doctor in exchange for prescribing drug X. The former is advertising, the latter is bribing. And there are lots of options on the market in terms of SSRI's, SNRI's, and many other medications. And there will only be more as more research comes about showing efficacy of drug X over Y.

And again, doctors that I have been with have always noted side effects and especially highly controlled substances like benzos, we make it clear that they can cause withdrawal symptoms and try our very best to avoid prescribing them in the first place. Not all doctors will do this, I agree, but that's a fault of the individual doctor, and not a fault of the general institution of traditional medicine and doctors which overall have been much more beneficial than detrimental to society as a whole.

It's natural for people to be concerned about side effects and I'm not advocating that doctors withhold that information, but in the end medicine is about being able to apply percentages. The likelihood that a patient responds positively to a medication far outweighs the likelihood that they experience one of the rarer side effects. With this is mind, it might occur to the doctor not to mention the 1 in 1000 chance of experiencing cardiac shock an manically depressed patient could otherwise benefit greatly from from taking Seroquel.


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## DarkSideOfLight

Senshu_Ben_Gone said:


> There are a few things in this post that I take issue with. *First, it's important to understand that pharmaceutical companies are not out to get anyone for the sake of profit.*


After that sentence I stopped reading. There are only 2 possibilities you are working for pharmaceutical company or you are being delusional. Let me tell you one thing if they have shareholders. And those that can afford FDA approval most likely have. They ARE obligated by the law to maximise profits. Forget about ethics, morals or well-being of sheep. Apply that to pharmaceutical, petrochemical, food industry, banking etc. then you will be able to see a small problem with the world we live in.


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## C3bBb

DarkSideOfLight said:


> After that sentence I stopped reading. There are only 2 possibilities you are working for pharmaceutical company or you are being delusional. Let me tell you one thing if they have shareholders. And those that can afford FDA approval most likely have. They ARE obligated by the law to maximise profits. Forget about ethics, morals or well-being of sheep. Apply that to pharmaceutical, petrochemical, food industry, banking etc. then you will be able to see a small problem with the world we live in.


Perhaps you should have read the entire post. Pharmaceutical companies are not out to get anyone. Yes, obviously they want to profit as a business but they don't do so by intentionally producing medications that they know won't work, or produce medications with overwhelming negative side effects. Reason 1 being that there's no way a drug company can profit off of defective medications since people would stop paying for these drugs anyway, and reason 2 being that drugs with significant defects would not even pass through the 4 rigorous clinical trials that it takes for pharmaceutical drugs to be FDA approved in the first place.

Please critically read my earlier post before posting knee-jerk reactions and assumptions.


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## Winds of Entropy

Tsaiireii said:


> I am biased as a pharmacy student, but herbal supplements are not regulated as drugs are, and clinical data is inconsistent and a lot of trials are poorly designed. You mention that it's safe if used as directed... but are you getting directed information from a professional? If not, I'd advise looking around for a healthcare professional that has experience w/ alternative medicine. Anecdotes from the internet do not guarantee safety.
> 
> They can cause serotonin syndrome; most drugs that affect mood like SSRIs have this risk. *You have to be careful with St. John's Wort and tyramine-rich foods as it can cause hypertensive crisis*, which is life-threatening (part of the serotonin syndrome). It also has a ton of drug interactions due to CYP450 enzymes, if you're taking other meds.
> 
> ETA: drug-drug interaction that may or may not be relevant for anyone reading: oral contraceptives. St. John's Wort is a CYP3A4 inducer, which basically means that it increases the metabolism of other CYP drugs. Your contraceptive will be less effective and breakthrough bleeding will increase.


Do you have a source for the bolded? I thought that was particularly with MAO inhibitors.



thismustbetheplace said:


> But I cant ask a "health professional" because as you say, theyre biased. Pretty much every psychiatrist has tried to bully me into taking antidepressants. If I could actually trust them to give me an informed opinion...but they are all shills for the pharmaceutical industry, which has a long history of not really giving a fuck about the people it treats, if that gets in the way of profit.
> 
> How regulated are psychiatric medications really? My high school best friend went on Prozac and became psychotic and intolerable to be atound. My dad went on Effexor and some other thing a few months ago. He has gained 50 pounds in 4 months, and has high blood pressure and has to take blood thinners which cause edema, when he NEVER had those problems before. I dont see him living another 10 years. Fuck. That. Shit. I would literally rather shoot black tar heroin than put that toxic shit into my body.


I understand your misgivings about using antidepressant drugs. It's hard to know who to trust, especially on things like psychiatric medications which _can_ help but can also cause some significant side effects. There is even bias in some of the studies done to evaluate the drugs (something I'm pretty sure you've alluded to). However, there've also been plenty of studies done without sponsorship and conflict of interests and such. Overall, antidepressants seem to be about as effective as psychotherapy, less effective than both done together, and slightly more effective than placebo. If you're worried about side effects, citalopram (an SSRI) is probably the safest bet, and I wouldn't really recommend anything else unless you have some special medical history to consider. But I already know how you feel about these ones.

St. John's Wort *taken every day* has been shown to be more effective than placebo for mild depression, so that's definitely a choice. As with all anti-depressants, give it 2-4 weeks to start working. Of course, it comes with its own side effects which I'm sure you can find online. I wouldn't bother taking 5-HTP, there's very little evidence for it. If something is going to work, it'll be the SJW. And don't take them together pls.

You mentioned cyclothymia - were you ever formally diagnosed? Taking antidepressants could cause a full-blown manic attack, and since SJW works in a similar fashion to SSRIs, there is that... theoretical risk. Probably not a big deal but it's something you should be aware of. Random thing outlining some case reports of mania w/ SJW: Mania and Psychosis Associated with St. John's Wort and Ginseng

ugh i was gonna type more but i'm too tired to remember everything. oh yeah, as a side note, blood thinners are used to prevent blood clots in situations like edema - so the edema is probably why he's on blood thinners. I don't know enough about his situation to really comment further, but yeah the weight gain might be due to Effexor unless he totally changed his diet/exercise habits. Why doesn't he talk with his doc about changing the medication?

EDIT: did he not have high blood pressure before either?

Also, it's funny that you don't wanna ask a health professional but future health professionals will likely flock to the thread anyways. Well, at least you know that with us there's no money involved. Just good will.


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## dragthewaters

Winds of Entropy said:


> I understand your misgivings about using antidepressant drugs. It's hard to know who to trust, especially on things like psychiatric medications which _can_ help but can also cause some significant side effects. There is even bias in some of the studies done to evaluate the drugs (something I'm pretty sure you've alluded to). However, there've also been plenty of studies done without sponsorship and conflict of interests and such. Overall, antidepressants seem to be about as effective as psychotherapy, less effective than both done together, and slightly more effective than placebo. If you're worried about side effects, citalopram (an SSRI) is probably the safest bet, and I wouldn't really recommend anything else unless you have some special medical history to consider. But I already know how you feel about these ones.
> 
> St. John's Wort *taken every day* has been shown to be more effective than placebo for mild depression, so that's definitely a choice. As with all anti-depressants, give it 2-4 weeks to start working. Of course, it comes with its own side effects which I'm sure you can find online. I wouldn't bother taking 5-HTP, there's very little evidence for it. If something is going to work, it'll be the SJW. And don't take them together pls.
> 
> You mentioned cyclothymia - were you ever formally diagnosed? Taking antidepressants could cause a full-blown manic attack, and since SJW works in a similar fashion to SSRIs, there is that... theoretical risk. Probably not a big deal but it's something you should be aware of. Random thing outlining some case reports of mania w/ SJW: Mania and Psychosis Associated with St. John's Wort and Ginseng
> 
> ugh i was gonna type more but i'm too tired to remember everything. oh yeah, as a side note, blood thinners are used to prevent blood clots in situations like edema - so the edema is probably why he's on blood thinners. I don't know enough about his situation to really comment further, but yeah the weight gain might be due to Effexor unless he totally changed his diet/exercise habits. Why doesn't he talk with his doc about changing the medication?
> 
> EDIT: did he not have high blood pressure before either?
> 
> Also, it's funny that you don't wanna ask a health professional but future health professionals will likely flock to the thread anyways. Well, at least you know that with us there's no money involved. Just good will.


So people take drugs that make them fat, psychotic and suicidal...and the actual benefits of these drugs are "slightly more effective than placebo"? Wow. It is really bad out there.

There seems to be evidence for 5-htp being effective too. But it hasnt been around as long so probably not as many studies.

I thought St Johns Wort acted like an MAOI not an SSRI.

Not formally diagnosed with cyclothymia but I definitely have something with (slight) mania followed by (moderate to severe) depression every few weeks. I literally cant find ANY psychiatrist in my area who takes my insurance AND has free evening or weekend hours, let alone a good psychiatrist.

I know about the blood thinners. My grandma just died of congestive heart failure 2 weeks ago...except she was 93, my dad is 59. They wont change the medication, he has been asking them but because its Medicaid they have about negative 2 fucks to give. No he didnt have high blood pressure before and his lifestyle otherwise is actually healthier now than before he went into this program.

Good will and sometimes an agenda, sadly...but I appreciate that you are attempting to have a more balanced perspective.


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## Biracial

Generally speaking, most people are on prescribed mood drugs. St. John's is known to have some very nasty interactions with antidepressants. I don't think 2 serotonins mixing is a good thing btw.


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## Winds of Entropy

thismustbetheplace said:


> So people take drugs that make them fat, psychotic and suicidal...and the actual benefits of these drugs are "slightly more effective than placebo"? Wow. It is really bad out there.
> 
> There seems to be evidence for 5-htp being effective too. But it hasnt been around as long so probably not as many studies.
> 
> I thought St Johns Wort acted like an MAOI not an SSRI.
> 
> Not formally diagnosed with cyclothymia but I definitely have something with (slight) mania followed by (moderate to severe) depression every few weeks. I literally cant find ANY psychiatrist in my area who takes my insurance AND has free evening or weekend hours, let alone a good psychiatrist.
> 
> I know about the blood thinners. My grandma just died of congestive heart failure 2 weeks ago...except she was 93, my dad is 59. They wont change the medication, he has been asking them but because its Medicaid they have about negative 2 fucks to give. No he didnt have high blood pressure before and his lifestyle otherwise is actually healthier now than before he went into this program.
> 
> Good will and sometimes an agenda, sadly...but I appreciate that you are attempting to have a more balanced perspective.


the incidence of side effects is usually slightly higher than placebo as well. The fact is that a lot of people are on antidepressants without being bothered by chronic negative effects.

edit: side effects are usually present in the first phase of drug therapy, but for a lot of people they go away after that. that's what I meant by the absence of chronic negative effects.

also, yeah it does act like an MAOI, you seem to be right - but if it was a strong MAOI it would interact with tyramine rich foods. There doesn't seem to be any warnings for that sort of thing though, so I'm guessing it's SSRI properties outweigh it's MAOI properties.


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## dragthewaters

Winds of Entropy said:


> the incidence of side effects is usually slightly higher than placebo as well. The fact is that a lot of people are on antidepressants without being bothered by chronic negative effects.
> 
> edit: side effects are usually present in the first phase of drug therapy, but for a lot of people they go away after that. that's what I meant by the absence of chronic negative effects.
> 
> also, yeah it does act like an MAOI, you seem to be right - but if it was a strong MAOI it would interact with tyramine rich foods. There doesn't seem to be any warnings for that sort of thing though, so I'm guessing it's SSRI properties outweigh it's MAOI properties.


Well a lot of people have unprotected sex with strangers without getting an STD, but that doesnt mean it's a good idea. Most people have some kind of side effect and a small percentage have serious side effects that can ruin or end their lives. Or they have to take 3 or 4 drugs to stop all the side effects.

St Johns Wort definitely isnt as strong as anything that would be prescribed. Otherwise it would have to be regulated. It seems safer than 5 htp but it seems that 5 htp balances out your moods, which is what I need, whereas St Johns Wort just makes you happier. Is that right? I dont really eat any of those tyramine rich foods anyway.



Biracial said:


> Generally speaking, most people are on prescribed mood drugs. St. John's is known to have some very nasty interactions with antidepressants. I don't think 2 serotonins mixing is a good thing btw.


I am not on antidepressants and have no plans to be.


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## Tsaiireii

thismustbetheplace said:


> But I cant ask a "health professional" because as you say, theyre biased. Pretty much every psychiatrist has tried to bully me into taking antidepressants. If I could actually trust them to give me an informed opinion...but they are all shills for the pharmaceutical industry, which has a long history of not really giving a fuck about the people it treats, if that gets in the way of profit.
> 
> How regulated are psychiatric medications really? My high school best friend went on Prozac and became psychotic and intolerable to be atound. My dad went on Effexor and some other thing a few months ago. He has gained 50 pounds in 4 months, and has high blood pressure and has to take blood thinners which cause edema, when he NEVER had those problems before. I dont see him living another 10 years. Fuck. That. Shit. I would literally rather shoot black tar heroin than put that toxic shit into my body.


What I said, technically, is that I was biased as a pharmacy student; I've been taught to be cautious about herbals, and I think for good reasons. Not that all healthcare professionals are biased... well, I think all people are to an extent biased, but that's not the point - physicians are supposed to follow guidelines for treatment and in addition to counseling, and that does sometimes mean medication. Also, if certain prescribers don't know a lot about St. John's Wort or aren't confident in the information available, they shouldn't be recommending it. They're liable if something happens that they didn't warn the patient about. 

I think you would be better off if you could find a professional who's had time to look over all the data available, like an alternative medicine specialist or something. If you really think that all doctors are just Big Pharma minions, then all I can tell you is that you're mistaken. If you don't want to take them, that's fine, I am in no way trying to make you take something you do not wish to. 


I should have been more specific about what I mean in regards to regulation. The safety, efficacy, and manufacturing standards for psychiatric/prescription medications are well-established and tightly regulated by the FDA (which does have some problems, but nevertheless). The average time between development and approval of a drug is something like 10 years; they're very well studied. Supplements, on the other hand, don't have to be proven effective/safe before they're marketed. The FDA is responsible for making sure drugs are safe through various processes, while for vitamins/etc. it's the manufacturer's responsibility to make sure things are safe and labeled appropriately.... which can easily create a problem. Contamination, non-labeled ingredients, and imported goods with lower manufacturing standards are rampant. GNC, Wal-Mart, other retailers deceptively labeling herbal supplements - report ? RT USA

For the record, I agree with you and other posters, drugs that affect your mood are not pleasant But when they're regulated, the side effects are known and information is available. What's on the label is correct. With herbals, you might not get what you think. 
@Winds of Entropy: I'd based my original post off of a drug database. Looks like there's controversy whether the MAOI effects that SJW has is clinically relevant, though it's apparently a strong MAOI in mice. Probably less so for humans, but there's no clear mechanism of action of the herbal identified for its effects either. Wish I could give a more straightfoward response, lol.


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## Winds of Entropy

thismustbetheplace said:


> Well a lot of people have unprotected sex with strangers without getting an STD, but that doesnt mean it's a good idea. Most people have some kind of side effect and a small percentage have serious side effects that can ruin or end their lives. Or they have to take 3 or 4 drugs to stop all the side effects.
> 
> St Johns Wort definitely isnt as strong as anything that would be prescribed. Otherwise it would have to be regulated. It seems safer than 5 htp but it seems that 5 htp balances out your moods, which is what I need, whereas St Johns Wort just makes you happier. Is that right? I dont really eat any of those tyramine rich foods anyway.


Taking antidepressants and having unprotected sex isn't really comparable. Antidepressants help with a chronic clinical condition. Unprotected sex is... unprotected sex. Here are some specific stats, I couldn't find them yesterday:

~54% of people get a response with drug therapy, 37% of people get a response with placebo. That's what I mean by "slightly more effective." i.e. there's about a 54% chance you could see an improvement in your symptoms with antidepressant therapy, and a 37% chance if you take placebo. Source: Does the probability of receiving placebo influence clinical trial outcome? A meta-regression of double-blind, randomized clinical trials in MDD. - PubMed - NCBI 

As for the side effects, the common ones usually subside after 2-4 weeks, around the same time that you really start seeing a benefit of the drug. So it pays to stick with them.

I wouldn't be able to say anything about the mood vs. happy thing. They've both shown some efficacy in specifically depression, and SJW has shown possible efficacy in stuff like menopause, plaque psoriasis, somatization disorder and wound healing (according to Natural Medicines Database). For everything else the evidence is conflicting/sparse/nonexistent.


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## KrumveLT

in fact kratom isn't an illegal drug
it's simply not certified drug...


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## Buttaphlybly

C3bBb said:


> There are a few things in this post that I take issue with. First, it's important to understand that pharmaceutical companies are not out to get anyone for the sake of profit. It doesn't make any sense business-wise for a drug that's shown to be harmful to the majority of the population to be released. No one would take them because they'd be harmful, right? And even if the drug showed to be harmful to a significant portion of the population, chances are it wouldn't even pass through the 4 rigorous clinical trial stages. This is a significant difference between your prescription drugs and your alternative medicines. Alternative medicines such as herbal supplements *do not *have to undergo clinical trials, nor do they need FDA approval prior to being marketed. This means that they can advertise whatever positive effect they may have and not need formal scientific confirmation in doing so, unlike your prescription drugs.
> 
> Secondly, it is markedly unfair to call health professionals "shills for the pharmaceutical industry." Health professionals do not receive any more compensation for prescribing tea and rest vs. prescribing NSAIDs or antibiotics. It's simply a matter of what's commonly scientifically accepted, and what's not. If you have strep throat, it's scientifically accepted and recommended to prescribe an antibiotic to get rid of the infection. There's no reward to prescribing anything, but also due in part to societal pressures and our constant need to have things resolved ASAP, doctors are forced to find quick fixes for people who need them. In other words, health care professionals are not all to blame for our obsession with drug prescriptions.
> 
> When you take an SSRI it is a common SIDE effect to experience weight gain. SOME, not all, patients who have been prescribed them have also gained weight as well. I work at a family medicine clinic, and I see a lot of different spectrums of people. Some react really well to certain SSRI's and some respond better to others. The field of psychiatry is complex because mental pain in itself is complex and it often requires a "mix and matching" of different drugs before we find out the right combination of drugs for a given situation. I would recommend looking into Viibryd which is an SSRI, but has not been shown to have weight gain as a common side effect.


In a perfect world I would say you are right...but then if you really take a long hard look at all of the prescription medications available and all of the terrible side effects they ACTUALLY DO have, and then you look at the many people willing to take the risk because they're desperate to rectify whatever problem they are having....it begs the question....why do the medications cost so much, if they can be offered at a fraction of the cost when they are a "generic"....and also ask yourself....if people got better from their treatment and the treatment had no side effects that usually is responsible for follow up visits to the doctor.....how long would our Healthcare professionals on the grand scale be employed.

There is definitely a cycle related to the drugs that are prescribed, the professionals that prescribe them, the money that is made from providing such services and the cost related to becoming such professionals. Parts of the cycle are unavoidable whereas other parts are intentionally placed and for the reasons of keeping the cycle a cycle.


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