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Doctors must do their homework about St. John's wort and other supplements

Harold Mandel's picture

There has been a growing interest in natural supplements to help reach for emotional well being due to increasing reports of catastrophic side effects which are often associated with psychiatric drugs. St. John's wort is a well known supplement for the treatment of depression. Overall this supplement is generally well tolerated. However, research has uncovered that there may be dangerous side effects when St. John's wort is mixed with many prescription drugs.

Researchers pursued a study of how often St. John's wort is prescribed with medications which have dangerous interactions with it reported The Journal of Alternative and Complementary Medicine. Patients from U.S. nonfederal outpatient physician offices who were prescribed St. John's wort between 1993 and 2010 were the subjects of this study. As EmaxHealth's Deborah Mitchell reported few days ago St. John's wort shouldn't be used with certain drugs. Today we are going to review why it is important for doctor's to be careful about prescribing St. John's wort and other supplements for patients.

St. John's wort is often used in combinations with drugs which may be dangerous

The researchers found that 28 percent of St. John's wort visits were associated with a drug that has potentially dangerous interaction with the supplement. The drugs involved included:

1: Selective serotonin reuptake inhibitors

2: Benzodiazepines

3: Warfarin

4: Statins

5: Verapamil

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6: Digoxin

Oral contraceptives

It was concluded that St. John's wort is often used in combinations which may be dangerous. Clearly physicians should be aware of these common dangerous interactions and warn their patients appropriately.

St. John’s wort is often used to treat depression

St. John’s wort is the leading complementary and alternative treatment which is used for depression in the United States reports Wake Forest Baptist Medical Center. According to a study by researchers at Wake Forest Baptist Medical Center St. John’s wort can be dangerous when it is taken with many commonly prescribed drugs. The researchers observed that this herbal supplement can decrease the concentration of many drugs in the body which results in impaired effectiveness and failure of treatment.

Physicians should communicate the risks of natural treatments with patients

Sarah Taylor, M.D., an assistant professor of dermatology at Wake Forest Baptist and lead author of the study, has pointed out that patients may have a false sense of safety with so-called natural treatments such as St. John’s wort. Dr. Taylor says it is important for physicians to know the dangers which are associated with natural treatments and to effectively communicate these risks to patients.

Dr. Taylor has discussed possible drug interactions with St. John’s wort. One possible interaction is a potentially fatal condition which causes high levels of the chemical serotonin to accumulate in your body. It is also possible to set off heart disease due to impaired efficacy of blood pressure medications. Also, unplanned pregnancy may occur due to contraceptive failure.

Action to deal with potential problems with St. John’s wort has been taken in some countries

Dr. Taylor has suggested there should be labeling requirements which provide appropriate
cautions and risk information for supplements which may have benefit such as St. John’s wort. Action to confront potential problems associated with the use of St. John’s wort has been taken in some countries. France has acted by banning the use of St. John’s wort products. Japan, Canada, and the United Kingdom are in the process of including drug-herb interaction warnings on St. John’s wort products.

This report helps to drive home the realization that it can be a tragic mistake to make the assumption that simply because a product is known as a natural supplement it is perfectly safe. St. John’s wort and other supplements should only be taken with caution as is true of anything which people consume.

Dr. Taylor is right to point out that doctors should be trained to always ask if the patient is taking any supplements, vitamins, minerals or herbs, particularly prior to prescribing any of the common drugs which might interact with them. Natural interventions often have a lot to offer in health care, but should always be used carefully. What this means is medical doctors must do their homework on how to advise people to use such supplements carefully.