# Wellbutrin + St Johns Wort? Good or bad?



## peaceandlove09 (Aug 10, 2010)

I am taking Wellbutrin with occasional 5 htp for sleep. 

Can Wellbutrin be combined with St Johns Wort for an extra boost? Or is this bad? 


Thanks,


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## aric (Aug 6, 2010)

Hi Eric,

I'd refrain from taking the St. Johns Wort with the Wellbutrin. Wellbutrin is a SSRI, and St. Johns Wort is also "believed" to be a SSRI as well. Combining the two, may possibly cause serotonin syndrome. I don't see any reason not to stop taking the 5-htp though.

Also, I will recommend on nights where sleep is crucial but you do not seem to be able to fall asleep, taking 25-50mgs of Diphenhydramine HCL (* Benadryl or Over the counter w/o pain reliever -- very important *) 30-45 minutes prior to going to bed can help put you to sleep. It's important though, if you take this method occasionally, to drink alot of water prior so the OTC medication can leave the body in a appropriate amount of time. Avoid eating large meals before bed, exercising, and or any stimulating activities and you should be fine. 

Good luck.


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## MBL (Oct 5, 2010)

I would not mix those.


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## Area88 (Oct 4, 2010)

Yeah ditto the above. Although St. Johns Wort is sold as a herbal supplement, it acts as an mild SSRI and should not be mixed with any prescribed antidepressant. It can cause drug interactions, including the very dangerous serotonin syndrome - http://en.wikipedia.org/wiki/Serotonin_syndrome

Either increase the dose of Wellbutrin or try a completly different medication if it's ineffective.


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## Freeflow918 (Jan 11, 2011)

I am currently trying this now. I've switched from Lexapro to SJW. Wellburtrin is suppose to work on Dopamine and Norepinephrine. I don't see how there could be any risk of Serotonin Syndrome.


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## jonny neurotic (Jan 20, 2011)

I tried taking a big handfull of StJohns Wort, standardised extract, tablets. I could not feel anything from them. So I doubt that they have any effect really. The science is patchy on the pharmacological effects.


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## QuietBoy99 (Sep 7, 2010)

Welluburtin + St Johns Wort doesn't sound like a good combination. You could try fish oil and take multivitamin by themselves not with prescribed medications.


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## blue the puppy (Jul 23, 2011)

kind of a side note, but someone above mentioned that wellbutrin is an SSRI. it is not. it is a "norepinephrine-dopamine reuptake inhibitor." it is sometimes given to offset some of the common side effects of SSRIs.


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## Witan (Jun 13, 2009)

peaceandlove09 said:


> I am taking Wellbutrin with occasional 5 htp for sleep.
> 
> Can Wellbutrin be combined with St Johns Wort for an extra boost? Or is this bad?
> 
> Thanks,


I asked my shrink this exact question when he started me on Wellbutrin, and he strongly advised against it.


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## Jesse123 (Dec 15, 2011)

Oh goodness gracious. Thankfully one person has already mentioned this, but it deserves a reiteration: Wellbutrin is NOT an SSRI, it is an NDRI (Norepinephrine Dopamine Re-uptake Inhibitor). It has no known impact on serotonin levels in the brain (apart from theoretically lowering serotonin due to dopamine/norephinephrine dominance). If you need an extra boost in addition to your Wellbutrin (which is common and very understandable) you could ask your doctor what he/she specifically thinks about this combo. Do NOT take SJW with 5-HTP however, nor should you ever combine SJW with an actual pharmeceutical SSRI (i.e., Zoloft, Lexapro, Prozac...etc.). Since SJW behaves similarly to an SSRI, it can create a risk for serotonin syndrome. 

I've heard of cases where psychiatrists approved of the combination of Wellbutrin and SJW but you MUST discuss this with your doctor before considering taking it. Part of Wellbutrin's metabolism takes place in the liver, which is where St. John's Wort is metabolized. For this reason, interactions could occur. 

Good luck in your treatment, and be well.


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## yaki (Aug 20, 2013)

Jesse123 said:


> Wellbutrin is NOT an SSRI, it is an NDRI (Norepinephrine Dopamine Re-uptake Inhibitor). It has no known impact on serotonin levels in the brain (apart from theoretically lowering serotonin due to dopamine/norephinephrine dominance). If you need an extra boost in addition to your Wellbutrin (which is common and very understandable) you could ask your doctor what he/she specifically thinks about this combo. Do NOT take SJW with 5-HTP however, nor should you ever combine SJW with an actual pharmeceutical SSRI (i.e., Zoloft, Lexapro, Prozac...etc.). Since SJW behaves similarly to an SSRI, it can create a risk for serotonin syndrome.


I know this is an old thread, and I registered just to respond to this but this needs reiteration. SJW and 5-HTP combined is dangerous because they both affect serotonin. 5-HTP crosses the blood-brain barrier therefore should also not be taken if pregnant or nursing. Wellbutrin affects dopamine receptors. 
My doctor switched me from W SR to XL last week. It has not been pleasant. I called today to be seen to get switched back, but I can't get in. I told her I didn't want to be switched in the first place because some people react badly to XL. I certainly did. I started "raging" about three days ago. I have behaved very inappropriately due to these rage fits.:mum I never had this before in my life. Since they wouldn't see me, I took two 300mg SJW's and the rage feeling went away. Hopefully I can keep taking SJW until the doctor sees me. I also want to indefinitely, so long as its effectiveness doesn't wear off. I was prescribed Wellbutrin for major depression.


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## T800 (Jun 13, 2013)

SJW is has many interactions. I cannot imagine at all that it can be combined with ANY antidepressant! I'd not try it.


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## ChopSuey (Nov 5, 2012)

derp.


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## basuraeuropea (Jul 25, 2012)

i generally agree with T800 - st. john's wort is a potent inducer of the cyp450 enzymatic system, cyp3a4 in particular, but also cyp1a2 and cyp2c9, the last of which isn't usually involved in the metabolism of antidepressants. combining, though, antidepressants that are metabolised by cyp3a4 and/or 1a2 isn't a great idea at all as efficacy can be compromised considerably. additionally, combining st. john's wort with the serotonergics can cause serotonin syndrome via st. john's wort's serotonergic properties. overall not a great idea.

aside from antidepressants, there are numerous other medications that are metabolised by said isoenzymatic systems and st. john's wort may interact deleteriously when combined. alwwwwaaaaayys check with your physician. online drug/supplement interaction checkers are also a great tool to use as adjuncts to your physician's advice.


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## ChopSuey (Nov 5, 2012)

basuraeuropea said:


> i generally agree with T800 - st. john's wort is a potent inducer of the cyp450 enzymatic system, cyp3a4 in particular, but also cyp1a2 and cyp2c9, the last of which isn't usually involved in the metabolism of antidepressants. combining, though, antidepressants that are metabolised by cyp3a4 and/or 1a2 isn't a great idea at all as efficacy can be compromised considerably. additionally, combining st. john's wort with the serotonergics can cause serotonin syndrome via st. john's wort's serotonergic properties. overall not a great idea.
> 
> aside from antidepressants, there are numerous other medications that are metabolised by said isoenzymatic systems and st. john's wort may interact deleteriously when combined. alwwwwaaaaayys check with your physician. online drug/supplement interaction checkers are also a great tool to use as adjuncts to your physician's advice.


Indeed, i was too hasty when i wrote my post. SJW has a broad range of effects and shouldn't be combined with SSRIs or TCAs, the risk of getting serotonin syndrome is possible with such a combination. But getting a lethal form of SS is close to impossible.


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## basuraeuropea (Jul 25, 2012)

ChopSuey said:


> Indeed, i was too hasty when i wrote my post. SJW has a broad range of effects and *shouldn't be combined with SSRIs or TCAs*, the risk of getting serotonin syndrome is possible with such a combination. But getting a lethal form of SS is close to impossible.


or a number of other psychotropics, antidepressant classes not listed above included.


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## ChopSuey (Nov 5, 2012)

basuraeuropea said:


> or a number of other psychotropics, antidepressant classes not listed above included.


Cool, anything else you want me to add to that list? Strawberries, whipped cream, banana peels or coconuts?


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## basuraeuropea (Jul 25, 2012)

ChopSuey said:


> Cool, anything else you want me to add to that list? Strawberries, whipped cream, banana peels or coconuts?


just things pertinent to the discussion at hand. if giving out medical advice, make sure it's sound before someone decides it's a good idea to take mirtazapine, for instance, and st. john's wort concurrently based on your advice.

thanks, chopsticks.


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## ChopSuey (Nov 5, 2012)

basuraeuropea said:


> just things pertinent to the discussion at hand. if giving out medical advice, make sure it's sound before someone decides it's a good idea to take mirtazapine, for instance, and st. john's wort concurrently based on your advice.
> 
> thanks, chopsticks.


So according to your medical expertise it's safe to take coconuts and SJW together?

And where have i written anything about mirtazapine spaniard? :3


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## basuraeuropea (Jul 25, 2012)

ChopSuey said:


> So according to your medical expertise it's safe to take coconuts and SJW together?
> 
> And where have i written anything about mirtazapine spaniard? :3


you didn't and therein lies the problem.

you made an erroneous, broad-sweeping statement followed by a misleading, broad-sweeping statement.

:3


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## depressed77 (Dec 9, 2010)

ChopSuey said:


> Cool, anything else you want me to add to that list? Strawberries, whipped cream, banana peels or coconuts?


Actually, that would be great, can you do that? Provided there is a proven interaction, of course.

/depressed77


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## ChopSuey (Nov 5, 2012)

basuraeuropea said:


> you didn't and therein lies the problem.
> 
> you made an erroneous, broad-sweeping statement followed by a misleading, broad-sweeping statement.
> 
> :3


So with your thinking it's wrong to say SSRI/TCA shouldn't be taken with SJW, as long as I don't include every substance in the world that can possibly have an adverse reaction with SJW?

Isn't that quite... weird Mr.Conquistador? <3


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## ChopSuey (Nov 5, 2012)

depressed77 said:


> Actually, that would be great, can you do that? Provided there is a proven interaction, of course.
> 
> /depressed77


No, it doesn't really matter to me, but since you seem quite interested in this thread.. Perhaps you could take on that job?


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## depressed77 (Dec 9, 2010)

ChopSuey said:


> No, it doesn't really matter to me, but since you seem quite interested in this thread.. Perhaps you could take on that job?


I believe it was your idea to add foods to list.

/depressed77


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## ChopSuey (Nov 5, 2012)

depressed77 said:


> I believe it was your idea to add foods to list.
> 
> /depressed77


http://en.wikipedia.org/wiki/Sarcasm

Living in a sauna, i can understand it's easy to misinterpret things in life.


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## depressed77 (Dec 9, 2010)

ChopSuey said:


> http://en.wikipedia.org/wiki/Sarcasm
> 
> Living in a sauna, i can understand it's easy to misinterpret things in life.


What's the matter with you, bad day? I won't respond to this thread again. You will just drag me down to your level and beat me with experience.

Bye.

/depressed77


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