St John’s Wort Contraindications?
Answered by: Conrad Richter
Question from: K Schumacher
Posted on: July 27, 1998

When taking antidepressants, you are warned not to drink alcohol and to stay away from certain types of over the counter medications. Since I have read that St Johns Wort works on the same basic principles (natural monoamine oxidase inhibitors and seritonin reuptake inhibitors) are there any contraindications for SJW as far as alcohol or other herbs or medicines? I am taking a variety of vitamins and herbs, and am worried about interactions with these or also alcohol.

St Johnswort is considered a relatively weak monoamine oxidase inhibitor. Still, as such, like all MAO inhibitors there are contraindications. Patients suffering from, or have suffered from, any of the following should consult their health care provider before taking St Johnswort (from Christopher Hobbs’ book "St John’s Wort: The Mood Enhancing Herb" -- available from Richters):

* congestive heart failure

* liver disease

* abnormal liver function tests

* severe impairment of kidney function

* cerebrovascular defects

* cardiovascular disease (such as arteriosclerosis)

* hypertension

* headaches

* over 60 years of age

Just because you suffer any of the above does not mean that you cannot take St Johnswort; instead, the likelihood is that you can take it safely. Still, as a precaution, a visit to your health care provider is recommended.

Patients taking MAO inhibitors must watch their intake of foods that are high in tyramine such as certain meats and cheeses. In addition, drugs such as Prozac, Paxil, diabetes drugs, stimulants containing ephedra or ephedrine-like compounds can cause interactions with MAO inhibitors and anyone taking these should see their doctor or herbalist before beginning treatment with St Johnswort.

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