St. John’s wort is a supplement derived from the Hypericum perforatum plant that is used to treat mild-to-moderate depression. While St. John’s wort is generally safe for short-term use, it can cause dangerous interactions with a wide range of medications, including Prozac. Understanding how St. John's wort works can help you reduce the risk of harmful interactions with other supplements and medications.
Pharmacology
St. John’s wort has many known uses, the most common being treatment of mild-to-moderate depression. It contains a number of compounds that are believed to have antidepressant effects. According to the National Institutes of Health, hyperforin is thought to be responsible for the majority of St. John’s wort’s effects. St. John’s wort may also be taken orally to help treat other conditions or applied topically to aid in wound healing.
Side Effects/Interactions
Like other drugs and supplements, St. John’s wort can cause unwanted side effects in some users. The National Institutes of Health lists vivid dreams, anxiety, stomach upset, dizziness and trouble sleeping as possible side effects of the supplement. When combined with other supplements or medications, St. John’s wort can cause harmful interactions. Taking St. John’s wort with the antidepressant Prozac can cause serotonin syndrome, a potentially fatal condition that occurs when excess serotonin is present in the body. Serotonin syndrome may also occur when combining St. John’s wort with other drugs in the same class as Prozac, such as Zoloft, Paxil or Celexa.
Safety Precautions
The best way to prevent interactions between St. John’s wort and Prozac is to avoid using both substances simultaneously. Because Prozac can remain in the body after discontinuing treatment, ask your doctor before taking St. John’s wort if you recently stopped taking the drug. Never quit taking Prozac abruptly, as this can lead to worsening depression symptoms. Follow dosing directions for St. John’s wort carefully and seek medical attention promptly if you experience trouble breathing, chest pain or other serious side effects.
Considerations
Because it is a dietary supplement, St. John’s wort is not tested for safety or effectiveness by the Food and Drug Administration prior to marketing. According to the National Center for Complementary and Alternative Medicine, the potency and purity of dietary supplements is sometimes unreliable for this reason. Choosing standardized St. John’s wort from a trusted manufacturer may help reduce the risk of contamination and other quality issues.
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