Posted by bleauberry on July 17, 2008, at 18:07:05
In reply to cymbalta plus herbs, posted by manic666 on July 17, 2008, at 5:04:03
You are pretty much in uncharted waters when combining meds and supplements. The two main things to research on your own would be:
Does the herb create any boost in serotonin via serotonin reuptake inhibition or maoi activity?
What liver enzymes metabolize cymbalta, which ones metabolize the herb, and does the herb speed up or slow down any of the enzymes that metabolize cymbalta? For example, st johns wort speeds up the metabolism of many meds, effectively creating lower doses of them and diminished effectiveness of them, done by speeding up the liver enzyme CYP3A4. It also slows down a different enzyme, which can triple the dose of zyprexa.
So you want to do a search at pubmed and google for "herb name + CYP" and see what you can find.
In the absence of any of this data, you can probably be safe by trying very small doses (1/8th to 1/4 minimum dose) for a few days before making any other changes.
All that said, most common herbs should be pretty safe I think, though I would still stick to very low doses to test the waters.
Herbs I've tried that were good for anxiety were:
Passionflower
Skullcap
Lemonbalm
Valerian
I used all of these, sometimes mixed, sometimes separetly, to survive the horrendous anxiety and insomnia of getting off zyprexa.And the so-called adrenal herbs (Siberian Ginseng, Ashwagandha, Astragulus, Reishi). I believe many anxieties are actually in the cortisol/adrenal axis. Was surprised my pdoc today said he believes most bipolar disorders are within the cortisol/adrenal axis. I found all those herbs quite calming and serene after a few days, but with Ginseng it has to be the Siberian one.
Other supplements:
Phosphatidylserine (good all around brain supp, but also dampens the cortisol response)
Lithium orotate
Magnolia extract
Reishi Mushroom extract120mg is a high dose, so I would be respectful with supplement dose sizes.
poster:bleauberry
thread:840119
URL: http://www.dr-bob.org/babble/20080706/msgs/840248.html