Jia Wei Xiao Yao Wan for Anxiety and Depression
Answered by: Conrad Richter
Question from: Karen
Posted on: November 28, 2006

I am currently suffering from anxiety and depression and have been prescribed Citalopram by my doctor. The dose was increased to 40mg 4 weeks ago. Whilst the medication has helped with some of my symptoms I still feel extremely anxious and am still suffering bad panic attacks.

I went to my local chinese herbal shop and asked if there was something they could recommend -- I was given Jia Wei Xiao Yao Wan.

Will this herb interact with my anti depressant medication?

Also, I am unsure how to take the pills as it was not explained to me properly -- could you advise me on this?

How long do I need to continue using the herb?

Your question, originally directed to Zhongfa Wu, was referred to me because Chinese herbal medicine practice is not Zhongfa’s area of expertise. He is expert in the botany, identification, culture and processing of Chinese herbs, but he is not trained as a herbalist. I have no training as a Chinese herbalist either, but my comments below derive from a book by Margaret Naeser called "Outline Guide to Chinese Herbal Patent Medicines in Pill Form" (Boston Chinese Medicine, 1990).

Jia Wei Xiao Yao Wan is Chinese patent medicine used to treat "liver stagnation". The words "Xiao Yao" mean "relieve Liver Stagnation", "Wan" means "pills", and "Jia Wei" means extra ingredients. This is a modification of a traditional formula that dates back about 1000 years.

In Chinese medicine terms, this formula opens up "Liver Qi", strengthens the spleen, and nourishes the blood. Typical symptoms of Liver Stagnation are headache, vertigo, dry mouth, dry throat, fatigue, poor appetite, moodiness, and possible irregular menstruation. What we call anxiety and panic attacks often include these symptoms, and likely your Chinese herbalist sees your condition as being caused by a blockage of your Liver Qi (pronounced "chi"). It is important to note that the Chinese concept of "Liver" in "Liver Qi" is not the strictly the same as the liver organ, although it is connected. So while you may wonder if your liver is not functioning properly, that may not actually be the case; rather in Chinese traditional medicine terms a diagnosis of Liver Stagnation has a more interrelated, systemic significance that isn’t easily mapped one-to-one with Western anatomical concepts.

The traditional formula (Xiao Yao Wan) has eight herbs including bupleurum, dong quai, and bai zhu. I don’t know what extra ingredients are added to the "Jia Wei" version.

The interactions between herbal medicines and drugs are, as a rule, poorly understood. I cannot see anything in the traditional formula that would pose an obvious risk of adverse or counterproductive effects when taken with antidepressants; but I don’t think anyone really knows.

The traditional formula is usually prescribed at a dose of 8-10 pills, 3 times a day. How long to take the formula is something your herbalist needs to determine after further assessment. For now, you should probably continue until you finish the bottle.

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