Posted by Sunnely on June 28, 2001, at 1:01:58
In reply to Kava VS. Benzodiazepines » Sunnely, posted by Areila on June 27, 2001, at 7:44:41
> I've heard that benzodiazepines such as Xanax, Valium and Librium combined with Zoloft also have negative combinational effects. Specifically the famous case of the man who was "in a semi-comatose state" after taking Kava and Xanax, which is actually a misconstruction of the facts, as he was on two other medications as well, with a possible four-way drug interaction, and apparently the three initial prescribed drugs alone could even have similar effects even without the Kava.
Pharmacokinetic-wise, there should be no clinically significant drug-drug interaction between sertraline (Zoloft) and alprazolam (Xanax). Xanax is mainly metabolized by the cytochrome enzyme CYP3A4. Zoloft does not interfere with the action of this enzyme. Same is true with diazepam or Valium (via CYP2C19) and chlordiazepoxide or Librium (via CYP2C19 and 3A4). In general, however, the combination of Zoloft and any of the benzodiazepines you mentioned is considered safe and well-tolerated.
With regard to the case of "semicomatose" patient, this is actually a 54-year-old man whose medications included cimetidine (Tagamet), terazosin (Hytrin), and Xanax. Reportedly, 3 days prior to his admission to a hospital in a "semicomatose" state, he started taking the "natural tranquilizer" kava. After several hours, he returned to an alert state. Indeed, this may not be just a case of drug interaction between Xanax and Kava. Cimetidine, itself is notorious for inhibiting a number of cytochrome enzymes that could lead to clinically significant interactions. Nonetheless, caution should be observed when taking Xanax or any centrally-acting depressant drugs with Kava.
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> However, I have not heard about Kava's dopamine antagonism. Could somebody reading the thread confirm this?This is just one case report of kava interfering with levodopa treatment in a Parkinson's patient, leading to reduced effectiveness and worsening of Parkinson's.
poster:Sunnely
thread:68025
URL: http://www.dr-bob.org/babble/20010625/msgs/68184.html