Can I Use St. John's Wort With My Bipolar Medication?

If you have bipolar disorder, a mental illness characterized by mood swings that fluctuate from depression to mania, you may turn to alternative treatments to reduce the amount of prescription medication you need to take. Many of the medications prescribed to treat bipolar disorder have significant side effects, such as weight gain, fatigue and depression. St. John's wort can add even more significant side effects; if you suffer from bipolar disorder, do not take this supplement without your physician's approval.

Uses

The herb St. John's wort, also known by the Latin botanical name Hypericum perforatum, comes from a yellow flower that has a long history of use for mental disorders. Today, St. John's wort has a reputation as an over-the-counter antidepressant. MayoClinic.com rates St. John's wort as an "A," meaning that there is strong evidence for its effectiveness in depression.

Side Effects

If you have bipolar disorder, St. John's wort may induce manic episodes or may lessen the time between mood changes. St. John's wort also interferes with a number of prescription medications, including antidepressants. Taking this herb with antidepressants may increase your risk of developing seratonin syndrome, a serious side effect characterized by agitation, elevated temperature, fast heartbeat, poor coordination, nausea, vomiting, tremor, hyperactive reflexes and hallucinations. St. John's wort could also produce suicidal or homicidal thoughts, MayoClinic.com warns.

Studies

Several studies have looked at the effects of St. John's wort on bipolar disorder. A joint report published in the December 1999 issue of "Biological Psychiatry" by researchers from Massachusetts General Hospital and Harvard Medical School reported on two cases where mania occurred in people without a previous history of mania. A Dutch case reported in the October 2001 issue of "Nederlands Tijdschrift Voor Geneeskunde" described a similar effect in a 23-year-old woman.

Considerations

Lack of compliance in taking prescribed antipsychotic medications runs high because of their side effects. As many as 50 percent of people with bipolar disorder don't take their medications as prescribed, according to a report published by Case Western Reserve researchers in the 2006 issue of "Bipolar Disorders." Some may turn to herbs instead. People suffering from depression may also self-medicate with over-the counter herbs such as St. John's wort. Since some people who take this herb may have occult, or as yet undiagnosed, bipolar disorder, St. John's wort carries a risk of precipitating mania in such patients, who doesn't realize they suffer from this disorder. Do not attempt to treat depression on your own with over-the-counter herbs.