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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3995
Experience:  MD Psychiatry
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Got a question ?Is it dangerous to used one 300mg of St Johns

Resolved Question:

Got a question ?Is it dangerous to used one 300mg of St John's Wort with Wellbutrin .I was using it 75 sr of Wellburtin in the morning andXXXXXJohn's Wort at 6pm in the afternoon and my doctor told me to stopped using St. John's Wort due to seizures.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.

Hello,

Kindly please tell me since how long have you been using this combination at these dosages.

I will get back to you once you reply to my query..

Regards

Customer: replied 1 year ago.


6 weeks.Right know I went up to a complete tablet 100Sr starting today.


I see that my BP is having less spikes than when I had 1/2 tablet.


Right know I staying any where from 119/80 to 129/92.I wonder if I can still can use 1 St John's Wort at 6pm until I see how I feel with 100 sr of Wellbutrin .If anxiety picks more I will use Buspar.

Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the valuable inputs.

The St. john's wort has no untoward interaction with wellbutrin SR so it can be used with it safely even at 100 mg dose of wellbutrin SR , and as far as it's current dose of 300 mg is concerned , it is well within the normal therapeutic range which is 300-600 mg / day , so yes you can still use st. john's wort in the afternoon and once the wellbutrin sr 100 mg gets settled in your system within 2-3 weeks you may decide on the fate of st. john;s wort which if even continued further may not have any potential side effect.

Kindly see the link below for more information on St. John's wort.

http://www.umm.edu/altmed/articles/st-johns-000931.htm

So to summarize..

-- There is no harmful interaction between st. john's wort and wellbutrin sr , especially at the present doses , so you shall continue taking both of them.

-- You have been able to tolerate the combination for past 6 weeks which is good enough time to show any such side effect of seizure if it was to occur in the first place.

-- You shall decide on the fate of St. John's wort after 2-3 weeks of wellbutrin sr 100 mg.

-- Buspar can be used as per the need.

I hope this helps.

Wish you all the best.

Take care.

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3995
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.


Need some help here: As you know I'm taking Wellbutrin 100sr once a day.This's my third day on this dosage. The anxiety in the morning still there.I'm taking klonopin .25 or less for the anxiety, if I go higher I would be sedated which I do not want. Also the hot flashes in my face from wellbutrin is bothersome ; is can of weird that the hot flashes bring my BP somewhat higher 138/89. Cons of Wellbutrin hot flashes, anxiety and elevation on BP and having trouble concentrating.


Pros for me no sexual side effects and not high heart rate while running or bicycling. I'm also taking St. john's Wort at 5 pm. Will be better if I try Buspar ?Do I have to taper 300mg of St. John's Wort ?Is wellburtin /buspar a good combination for me or should I changed to another anti-depressant that works both with anxiety and depression and Blood Pressure?

Expert:  Dr. Kaushik replied 1 year ago.

Hi there,

Well yes Buspar should now be tried as it will take care of your anxiety and stress induced blood pressure but you need to first come off St. John's wort by taking it on alternate day for 7 days , followed by St. John's wort taken once in every 3rd day for next 10 days and then stopping St. John's wort completely.

Buspar can be started when you have come down to taking St. John's wort once in every 3rd day.It needs to be started at 10 mg dose twice a day.

I believe at this point addition of Buspar to wellbutrin sr will be a more plausible solution to your current set of symptoms.

I hope this helps.

Wish you all the best.

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3995
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.


Have question. Friend tells me that Buspar will not do much for my anxiety since I have being using Klonopin for more than 3 years.


Is that true?I still taking klonopin in the morning and at night-0.25mg.


 


reg,


Edward

Expert:  Dr. Kaushik replied 1 year ago.

Well yes that is the general perception of people that after use of klonopin for long duration Buspar may not work effectively but it is not always the case so i cannot totally refute your friend's claims but i believe buspar at dose of 10 mg twice a day has got in it what it takes to manage anxiety so i will still encourage it's use despite of long term use of klonopin.

But i request you to please give buspar at least 3-4 weeks time to respond as it is slower in onset but once it settles in the system it is second to none in producing positive effects on treating anxiety.

I hope this helps.

Regards

Customer: replied 1 year ago.


yesterday I had bad reaction I did not take the St john's Wort at 6pm ,I'm 1 day yes one day no, instead I took 1/4 of klonopin for my anxiety


,suddenly I started to get real hot like my face and extreme heat even my


BP went up 138/100.Than 1 hour later is like my body temperature dropped significantly I was shivering .It lasted like 15 minutes than everything went back to normal.It looks like even 100 RS of Wellbutrin brings more anxiety than what I have. I wonder if Cymbalta will give me higher BP or spikes?

Expert:  Dr. Kaushik replied 1 year ago.

Well it seems like that the uncomfortable episode which you experienced was a panic attack which could have precipitated on it's own as an extension of your underlying anxiety disorder. And it is not likely to be a result of wellbutrin SR as such side effect of this drug is not usually seen.

Well cymbalta is not generally associated with higher blood pressure or spikes but yes there can be palpitations / raised and pounding heart beat associated with it but this too is not that common in it's users.

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3995
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

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