Does Mirtazapine interact next to any of these herbal medicine?
-St. John's Wort
- Ginkgo biloba
- Milk thistle
- Valerian root
-5-HTP
I'm currently taking the herbal stuff for various things, such as anxiety and depression, but my shrink has recently prescribed me Mirtazapine. I haven't started taking it however, and I need to know which of the herbs I would have to stop taking. If it comes down to a choice, do you suppose it would be better for me to stick with the herbal remedies or go with the chemicals?
Answers:
Hey,
St. Johns Wort: Remeron (mirtazapine) and St. John's wort (Major Drug-Drug)
MONITOR CLOSELY: Concomitant use of agents beside serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status change such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. DO NOT MIX.
Ginkgo Biloba: Remeron (mirtazapine) and Ginkgo biloba (ginkgo) (Moderate Drug-Drug)
GENERALLY AVOID: Certain preparations of ginkgo biloba have be reported to induce seizures. There may be a theoretical risk of increased seizure potential when used next to other agents that can lower the seizure threshold such as selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, and theophylline. Ginkgo products may contain varying amounts of 4'-O-methylpyridoxine (ginkgotoxin), a particular neurotoxin found primarily in ginkgo biloba seeds but also detected in low-grade amounts in the leaves. In vivo, 4'-O-methylpyridoxine competes with vitamin B6, which causes an indirect inhibition of glutamate decarboxylase and subsequent diminution in the formation of gamma-aminobutyric acid (GABA) in the brain. There hold been published case reports of generalized convulsions and vomiting within several hours after ingestion of sizeable amounts of ginkgo nuts/seeds, including in young children and healthy individuals beside no known personal or family history of epilepsy. Many more cases, including fatalities, occurred surrounded by Japan in the 1930s to the 1960s during a food shortage when ginkgo nuts served as an important source of food. Some investigators have suggested that the amounts of ginkgotoxin contained by commercial extracts are too low to exert a detrimental effect. Nevertheless, a case report describes two elderly, previously well-controlled epileptic patients who presented with recurrent seizure within two weeks of initiating treatment with a ginkgo extract. Both patients remained seizure-free several months after discontinuing the extract, with no alteration to their anticonvulsant medication. SHOULD NOT MIX.
Milk Thistle: Okay to mix these two medications together.'
Valerian Root: Remeron (mirtazapine) and Valerian (Moderate Drug-Drug)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that end in these effects, especially in elderly or debilitated patients.SHOULD NOT MIX.
5-HTP: Remeron (mirtazapine) and 5-Hydroxytryptophan (Major Drug-Drug)
MONITOR CLOSELY: Concomitant use of agents with serotonergic hum such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. DO NOT MIX.
Hope this helps, Source(s): http://www.drugs.com/drug_interactions.h…
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- Ginkgo biloba
- Milk thistle
- Valerian root
-5-HTP
I'm currently taking the herbal stuff for various things, such as anxiety and depression, but my shrink has recently prescribed me Mirtazapine. I haven't started taking it however, and I need to know which of the herbs I would have to stop taking. If it comes down to a choice, do you suppose it would be better for me to stick with the herbal remedies or go with the chemicals?
Answers:
Hey,
St. Johns Wort: Remeron (mirtazapine) and St. John's wort (Major Drug-Drug)
MONITOR CLOSELY: Concomitant use of agents beside serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status change such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. DO NOT MIX.
Ginkgo Biloba: Remeron (mirtazapine) and Ginkgo biloba (ginkgo) (Moderate Drug-Drug)
GENERALLY AVOID: Certain preparations of ginkgo biloba have be reported to induce seizures. There may be a theoretical risk of increased seizure potential when used next to other agents that can lower the seizure threshold such as selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, and theophylline. Ginkgo products may contain varying amounts of 4'-O-methylpyridoxine (ginkgotoxin), a particular neurotoxin found primarily in ginkgo biloba seeds but also detected in low-grade amounts in the leaves. In vivo, 4'-O-methylpyridoxine competes with vitamin B6, which causes an indirect inhibition of glutamate decarboxylase and subsequent diminution in the formation of gamma-aminobutyric acid (GABA) in the brain. There hold been published case reports of generalized convulsions and vomiting within several hours after ingestion of sizeable amounts of ginkgo nuts/seeds, including in young children and healthy individuals beside no known personal or family history of epilepsy. Many more cases, including fatalities, occurred surrounded by Japan in the 1930s to the 1960s during a food shortage when ginkgo nuts served as an important source of food. Some investigators have suggested that the amounts of ginkgotoxin contained by commercial extracts are too low to exert a detrimental effect. Nevertheless, a case report describes two elderly, previously well-controlled epileptic patients who presented with recurrent seizure within two weeks of initiating treatment with a ginkgo extract. Both patients remained seizure-free several months after discontinuing the extract, with no alteration to their anticonvulsant medication. SHOULD NOT MIX.
Milk Thistle: Okay to mix these two medications together.'
Valerian Root: Remeron (mirtazapine) and Valerian (Moderate Drug-Drug)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that end in these effects, especially in elderly or debilitated patients.SHOULD NOT MIX.
5-HTP: Remeron (mirtazapine) and 5-Hydroxytryptophan (Major Drug-Drug)
MONITOR CLOSELY: Concomitant use of agents with serotonergic hum such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. DO NOT MIX.
Hope this helps, Source(s): http://www.drugs.com/drug_interactions.h…
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