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A.  PRECAUTIONS:       First:     Don’t self-treat serious depression!  SEEK IMMEDIATE HELP IF     YOU ARE HAVING SUICIDAL THOUGHTS.     Depression is a very serious illness and the suicide rate in     untreated depression is at least 15% over the long term.  An     occasional case of the blues is one thing; a depression that     lasts for weeks or months or where you have frequent thoughts     of killing yourself is a whole different matter. Because     depression so strongly affects a person’s view of reality,     it’s very important for folks with depression to have someone     else to check in with who can tell if things are to the point     where suicide is a real risk.     Most cases of depression ARE treatable and if people need     more information, I suggest that they check in on     alt.support.depression and/or consult a physician or     therapist. Call the local suicide prevention hotline (listed     in the front of most phone books) if you have thoughts of     killing yourself.     SUGGESTED PATIENT INSTRUCTIONS: (Health providers may     duplicate and pass out this section without violation of     copyright)     a.  Immediately discontinue St. John’s wort and consult a         physician if you develop the following symptoms:         *  Confusion or a feeling of being "high" or disoriented;         *  Difficulty with speech         *  Fever not known to be due to a cold or the flu;         *  Unexplained sweating;         *  Shock-like contractions of the muscles anywhere in the            body, including the mouth, tongue and throat (which may            be felt as a "fluttering" sensation;         *  Severe headache, particularly in the back of the head            or over the temples, which may be "pounding" and            worse when lying down;         *  A sudden rise in blood pressure of more than 30 points            or higher than 180/100.         *  Pupil dilation;         *  Rigidity of neck muscles;         *  Heart palpitations or a racing and/or irregular heartbeat     b.  Don’t take St. John’s wort with other antidepressants         including SSRIs and tricyclic antidepressants unless you         are under a doctor’s close supervision.     c.  Do not take St. John’s wort with MAOIs (monoamine oxidase         inhibitors).  If you are discontinuing or beginning an         MAOI, allow a minimum of 4-8 weeks between use of St.         John’s wort and the MAOI.         Note: Most MAOIs are prescription antidepressants.  If         you are taking a prescription antidepressant and are not         sure if you are taking an MAOI, ask your physician.         However, this precaution also applies to certain herbs         that contain MAOIs, particularly yohimbe and doses of         licorice root in excess of 5 grams per day.     d.  Do not stop taking prescription antidepressants without         proper medical care.  If stopping an MAOI, wait a minimum         of 4 weeks before taking any other antidepressant         including St. John’s wort.  If stopping St. John’s wort         to begin MAOI therapy, wait 8 weeks before beginning the         MAOI.     e.  Persons using whole herb St. John’s wort products, or who         are using a product not confirmed to be a properly purified         alcoholic extract should follow the full list of precautions         for those using MAOI drugs.         For a full list of foods and drugs known to adversely         interact with MAOIs, see Dr. Bob’s psychopharmacology web         page at:         http://uhs.uchicago.edu/~bhsiung/tips/maoi.html     f.  Do not take St. John’s wort for bipolar ("manic-depressive")         illness.     g.  Do not take St. John’s wort if you have a history of         seizure disorders.     h.  Do not take St. John’s wort if you are pregnant or breast         feeding.     i.  Do not use St. John’s wort if you have previously         developed a rash from it or if you are allergic to it.     j.  Wear a sunscreen while using it, particularly if you are         fair skinned.     k.  Use care if you have a history of photosensitive rash or         if you are taking certain medications that can cause         photosensitive reactions such as tetracyclines, Thorazine         (chlorpromazine) or Tegretol (carbamazepine).     l.  Avoid theraputic ultraviolet therapy and/or tanning         salons while using St. John’s wort.     m.  Do not take St. John’s wort with haloperidol or other         drugs known to decrease dopaminergic activity because         they may reduce the efficacy of St. John’s wort.     n.  Stick to the standard dosage or the dose on the bottle         and don’t keep increasing the dose if it’s not working.     o.  If you have a serious systemic illness, do not take St.         John’s wort or any other herb without the supervision of         a physician.     p.  Do not take St. John’s wort if you have an estrogen         dependent cancer, such as certain breast and uterine         cancers.  St. John’s wort contains a mild phytoestrogen.         Even though the estrogenic agent in St. John’s wort does         not appear to affect breast tissue, not enough is known         to state that it is safe to use in people with breast         cancer. This agent DOES stimulate uterine and         ovarian tissue.     q.  Like all drugs, herbal or otherwise, St. John’s wort         should not be left within the reach of small children. B.  DOSAGE AND ADMINISTRATION:     Unless otherwise prescribed, the standard dose is 2 to 4     grams of the raw herb or 0.2 to 1.0 mg of extracted hypericin     per day. Some depression studies have used as much as 2.7 mg.     of hypericin per day.     Alcohol extracts standardized for hypericin content are the     only form of St. John’s wort that should be consumed     internally.     Almost all medical studies have been conducted using a     particular alcohol extract called LI 160. This is also sometimes     called research grade hypericum.  (Note: the alcohol is used     during the extraction process but does not remain in the end     product, so LI 160 is safe for use by recovering alcoholics.)     We do not know if other forms, such as chopped raw St. John’s     wort or a tea, are as effective in treating depression or     other illness.  There is also the consideration that the oily     residue of alcohol extraction may be the fraction that contains the     MAOI and possibly agents that cause birth defects.     However, St. John’s wort can also be consumed in the     following ways:     Max Wichtl states in _Herbal Drugs and Phytopharmaceuticals_     that St. John’s wort can be taken orally as chopped or     powdered herb, a liquid or semi-solid preparation or a     water/grain alcohol tincture.  Tea bags containing 2 grams of     the raw herb are also available.     A tea can be made of St. John’s wort by pouring about 1 cup     of boiling water over 2 teaspoons (2-4 grams) of chopped raw     herb, waiting for 5-10 minutes, then straining.     1 teaspoon of finely chopped St. John’s wort equals about     1.8g.     (Even though Wichtl says to steep the herb, it’s not clear to     me whether simmering the herb might not be better.  Slowly     simmering an herb tends to boil off the volatile oils;     however, I don’t know if this also means that the solution     picks up more of the oil as well. To simmer an herb, bring to     a boil and then turn the heat down to where only a few     bubbles reach the surface.  Leave for 20 minutes.)     Two cups of the freshly prepared tea are drunk regularly     morning and evening. (It’s unclear in Wichtl, but given that     the normal dose is 4 grams per day, I assume this means that     the dose is divided into one cup in the A.M. and one in the     P.M.)     Oily preparations are made by soaking St. John’s wort flowers     in glycerin or in olive, sunflower or wheatgerm oil.     Wichtl states that it is necessary to use the compound over a     period of several weeks or months to notice an effect.[2]     It’s possible that the sedative effects of St. John’s wort     may be felt quickly but that, like other antidepressant     agents, it may take several weeks for the antidepressant     effect to be noticeable.

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Thank you very much for the information. All three posts were well done. BTW, this has as many or more precautions and contraindications than that that mean old "R" drug. Just a thought. Tom Boland

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Thank you very much for the information. All three posts were well done. BTW, this has as many or more precautions and contraindications than that that mean old "R" drug. Just a thought.

, thanks Tom , i identify herbs as being drugs as well ( or at least haveing Drug like effects )  …. i am very cautious of them …and only use them occasionaly …. like ginkgo biloba….

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i take ritalin for my add. i also have (relatively) mild depression, caused i believe from having add. at one time i did take prozac, and it helped at first, then after awhile it stopped working so i went off it. i tried some other types of meds that turned me into a zombie, so i just took ritalin. then i heard of st. john’s wort, and decided to try it. it does work for me, but i have heard of others whose depression is worse than mine that it did not work for. the recomended dosage is 3 capsules a day, i usually only have to take one. except for certain times of the month -grin-. i don’t know if it works for me because my depression isn’t that bad or because of my body chemistry, or what. the point is (yes there is one) that i take ritalin for my add because that is what it is for. i take st. john’s wort for my depression because it does help for that. i do not take st. john’s wort for my add, nor do i expect it to help my add. i have nothing against taking "natural" medicines for what they are for. none have been shown to help with add. ritalin has, so i take ritalin for my add. this is what works for me. kim

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Did the others take the same product that you were taking in St. Johns Wort .. it may make a difference , one might be more potent than the other … but then it can be ruled that the suppliment may not be the answer to that particular person … again no magic bullet … their may be alot of differnt reasons that the herb didnt work for them Aloha Frank

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