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St. John’s Wort: Good for the Mind and Heart

Can drug-herb interactions can actually be a good thing? Absolutely.

It seems a common worry in the world of conventional medicine that the herbs can cause harm, and negatively interact with prescribed medications. Certainly, there are legitimate reasons for concern, especially since a large percentage of patients do not tell their doctor they are taking natural remedies (mostly due to worry over disapproving reaction). But there is a body a research starting to show that nutrients and herbs may actually be of benefit to people taking drugs. We need to start thinking about the positive impact natural remedies can have when used with conventional medicines.

For instance, St. John's wort (Latin name: Hypericum perforatum) is considered a bit of a menace in the conventional world. Because of its ability to change the liver's ability to process medications, it is considered one of the taboo herbs if you are on any other medication.

The truth: By the same mechanism St. John's wort may negatively change the effect of a medication by possibly increasing or decreasing its level of effect, it could also help. Known for its ability to stave off depression, it is not well known that the psychiatric-geared St. John's wort may be gaining ground in the field of cardiology, and may be a good example of an herb that can help a drug actually work better.

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St. John's wort is already well-known to work well to beat depression in heart patients, with less negative side effects on the heart than traditional antidepressants. For patients with cardiac electrical issues (such as arrhythmias) or in elderly patients with heart problems, high-dose hypericum extract has been found to be safer for the heart than tricyclic antidepressants (such as Elavil, Imipramine, and Amitrpytiline). As a result, some researchers are thinking it makes sense to use St. John's wort as a first line therapy for cardiac patients with depression.

Two other studies also suggest St. John's wort may even help patients lower the dose of Plavix (an anticlotting drug), and can help in the 20 percent of patients who are treatment resistant (meaning that for these patients the drug would normally not work). One study using clopidogrel (Plavix) found that 2 out of 10 patients using this drug does not work well, but in these patients, 300mg of St. John's wort, for two weeks, boosted the anti-platelet effect by 20 percent. A past study using 300mg three times a day of this botanical showed an increased drug effectiveness of 36 percent.

Although doctors were concerned that the St. John's wort might negatively change the effectiveness of the patients' cholesterol lowering statin drugs, no negative change in cholesterol was seen.

In conclusion, we are learning that drug-interactions are not necessarily a bad thing. When used properly, herbs like St. John's wort may be a great choice for heart patients by helping get a good effect using less toxic medications and allowing drugs to work better.

Coming up: Folate for treatment resistant depression

References:

Czekalla J, Gastpar M, Hubner WD, Jager D. The effect of hypericum extract on cardiac conduction as seen in the electrocardiogram compared to that of imipramine. Pharmacopsychiatry. 1997 (30) Suppl 2:86-8.

Lau WC, Gurbel PA. Annual Scientific Session Of The American College Of Cardiology. May 2010. Elsevier global medical news, accessed on July 7, 2010.

Also see:
Bongiorno PB, LoGiudice P. Hypericum. NMJ 2010; 2(12).

Peter Bongiorno is a naturopathic doctor and author of Healing Depression: Integrated Naturopathic and Conventional Treatments.

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