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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for side effects of St. John's wort

Answered by
Dr.
Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Mon, 6 Jun 2016 in Mental Health
Question: I came off Paxil 5 days ago because I was getting akisthisia with it after 3 weeks. I was on it for anxiety. I suffered with some terrible agitation restless withdrawals which resolved. And I was left with my usual underlying anxiety. A friend gave me some St. John's wort which I foolishly took for the last 2 days. Today terrible agitation again. Could this be due to the St. John's wort?
doctor
Answered by Dr. Chintan Solanki 36 minutes later
Brief Answer:
yes it can be due to St. john's wort

Detailed Answer:
Hello,

Thanks for writing to us.I can understand your concern.

St. john's wort contains hypericin (others under investigation). It has dopaminergic and serotonergic activities. This may lead to agitation. Agitation is very common side effect of St. john's wort. In your case same has happened likely. Please stop St. john's wort.

I recommend low dose benzodiazepine for your anxiety for a while. Please ask your doctor for the same.

Qutiapine or escitalopram is good option for your anxiety.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 13 minutes later
Any idea how long it cud last? Im hoping to sleep it off
doctor
Answered by Dr. Chintan Solanki 11 minutes later
Brief Answer:
approximately 24-48 hours

Detailed Answer:
Hi,

Thanks for follow up.

I am sorry that there are no specific details available about metabolism of St. John's wort. However you have taken it only for 2 days so agitation should be stopped within 24-48 hours maximum. If you are more uncomfortable, please consult ER for symptomatic relief through anti anxiety medicines.

Take care dear.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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