St john's wort withdrawal symptoms

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St. John's Wort Withdrawal Symptoms: An Overview

Introduction to St. John's Wort and Its Uses

St. John's Wort (SJW) is a popular herbal supplement primarily used for the treatment of depression. Despite its widespread use, the pharmacology, effectiveness, and safety of SJW are not well-documented, leading to potential adverse outcomes when used without medical supervision .

Potential for Withdrawal Symptoms

Evidence from Methadone Maintenance Treatment

A case report highlighted the interaction between SJW and methadone, a medication used in maintenance treatment for opioid dependence. The introduction of SJW significantly reduced methadone plasma levels, leading to withdrawal symptoms in some patients. This suggests that SJW can induce withdrawal symptoms by decreasing the effectiveness of other medications, necessitating careful management to avoid discomfort and potential relapse into illicit drug use .

Consumer Survey Insights

A survey of 43 subjects who had taken SJW revealed that 13 individuals experienced withdrawal symptoms upon discontinuation of the supplement. Additionally, two individuals reported a depressive relapse after stopping SJW. These findings underscore the need for greater awareness among consumers and healthcare providers regarding the potential withdrawal effects associated with SJW .

Ineffectiveness in Smoking Cessation and Withdrawal Management

Randomized Clinical Trials

Two randomized clinical trials investigated the efficacy of SJW for smoking cessation. Both studies concluded that SJW did not significantly aid in smoking cessation or reduce withdrawal symptoms. In one trial, participants taking SJW did not show higher abstinence rates compared to those taking a placebo, and no significant side effects were noted 14. Another trial also found no significant difference in prolonged abstinence rates between the SJW and placebo groups, further indicating that SJW is ineffective in managing withdrawal symptoms related to smoking cessation .

Conclusion

St. John's Wort, while commonly used for depression, has been associated with withdrawal symptoms, particularly when interacting with other medications like methadone. Surveys and clinical trials indicate that SJW does not effectively manage withdrawal symptoms, whether related to smoking cessation or other conditions. These findings highlight the importance of medical supervision when using SJW to mitigate potential adverse effects and withdrawal symptoms.

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Most relevant research papers on this topic

A proof of concept randomised placebo controlled factorial trial to examine the efficacy of St John's wort for smoking cessation and chromium to prevent weight gain on smoking cessation.

St John's Wort is ineffective for smoking cessation, while chromium may prevent weight gain after quitting smoking.

RCT

2009·

28citations

·A. Parsons et al.

Methadone maintenance treatment and St. John's Wort - a case report.

St. John's Wort may decrease methadone blood levels and induce withdrawal symptoms in patients in methadone maintenance treatment, potentially leading to discomfort and discontinuation of treatment.

Case ReportHighly Cited

2003·

84citations

·D. Eich-Höchli et al.

Consumer Use of St. John's Wort: A Survey on Effectiveness, Safety, and Tolerability

St. John's Wort is a potentially risky self-care treatment for depression, with 47% reporting side effects and a need for greater consumer and provider awareness of potential risks.

Observational Study

2000·

62citations

·Stephanie E. Beckman et al.

A randomized clinical trial of St. John's wort for smoking cessation.

St. John's wort did not increase smoking abstinence rates in this randomized trial, suggesting it has little role in treating tobacco dependence.

RCT

2010·

28citations

·A. Sood et al.

Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis.

St John's wort has comparable efficacy and safety compared to SSRIs for patients with mild-to-moderate depression.

Meta-AnalysisRigorous JournalHighly Cited

2017·

202citations

·Q. Ng et al.

Drug Interactions with St John’s Wort

St John's Wort may reduce the efficacy of co-medications, but with proper precautions and contraindications, quality-tested products can be used safely and effectively for mild to moderate depressive disorders.

Systematic ReviewHighly Cited

2001·

202citations

·M. Mannel

Interaction of St John's wort (Hypericum perforatum) with clozapine.

St John's wort self-medicating can worsen psychiatric symptoms in patients with schizophrenia, potentially due to its induction of P450 enzymes and P-glycoprotein.

Case ReportRigorous Journal

2012·

47citations

·Annelies C P Van Strater et al.

Drug interactions with St John's wort : mechanisms and clinical implications.

St John's wort may reduce the efficacy of co-medications, but with proper precautions and contraindications, quality-tested products can be used safely and effectively for mild to moderate depressive disorders.

Systematic ReviewHighly Cited

2004·

110citations

·M. Mannel

St John's wort: a systematic review of adverse effects and drug interactions for the consultation psychiatrist.

St. John's wort is effective for short-term management of mild-to-moderate depression, but may interact with certain drugs, requiring further research.

Systematic ReviewHighly Cited

2003·

129citations

·Paul G. Hammerness et al.

Pharmacokinetic Interactions of Drugs with St John’s Wort

St John's Wort may interact with various drugs, causing potential safety concerns and requiring further research on herb-drug interactions.

Systematic ReviewHighly Cited

2004·

224citations

·Shufeng Zhou et al.

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