posted
Does anyone have a good resource to look up interactions between herbals and pharmaceutical drugs?
I have my Physician's Desk Reference book, but that only covers the pharmaceuticals.
I worry sometimes about possible interactions between supplements and prescription meds.
The pharmacist doesn't give me any information about the herbals and supplements.
Let me know if anyone has a good website or book!
Thanks, chicago bird
p.s. The combo I'm wondering about lately: SAM-e + klonopin?
Posts: 69 | From Chicago, IL | Registered: May 2006
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CherylSue
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Hi Chicagobird, I'm from Chicagoland, too. I don't think SamE is a good combo with klonopin. I was wondering about klonopin myself with abx, but I guess that's okay.
CherylSue
Posts: 1954 | From Illinois | Registered: Aug 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
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THE INTERACTIONS OF HERBS AND DRUGS. by Subhuti Dharmananda, Ph.D. 2000
The Journal of Alternative and Complementary Medicine Herb-Drug, Food-Drug, Nutrient-Drug, and Drug-Drug Interactions: Mechanisms Involved and Their Medical Implications
Janina Maria S�rensen, MSc, MH Allinge, Denmark.
To cite this paper: Janina Maria Sorensen. The Journal of Alternative and Complementary Medicine. June 1, 2002, 8(3): 293-308. doi:10.1089/10755530260127989.
The cytochrome p450 enzymes, their role in metabolism, and their mechanisms of action are reviewed, and their role in drug-drug interactions are discussed.
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Whether a drug and herb interact may be determined by which, or both, if they use the C P-450 pathway. Excess porphyrins can result in serious medical situations, which are not exactly interactions or side-effects per se, so some study to this might be helpful.
SECONDARY PORPHYRIA: what you should know before starting a CAP
this article can help explain some of that - whether treating Cpn or lyme, or whatever, this article is relevant as 60% of our drugs use the C P-450 pathway.
Much of everything else we come into contact with - even by breathing - such as perfumes, car exhaust, etc. much filters through that detox pathway of the liver.
Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
There is nothing that is completely comprehensive. Supplements don't get approved by the FDA so there are very limited safety studies. Many don't have any studies at all.
There are some compilations, as linked to above, but remember they won't have everything in them. So you have to reach each one to see if there are studies of interactions.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
CherylSue, hope this helps: I take a tiny nib of Klonopin every night to help with sleeping. And I have taken it when I am on abx regimens, with the OK of my LLMD, and I haven't had any ill effects.
P.S. But don't take my word for it! Better check with your pharmacist or doctor...
Keebler, thank you for all the links! I will look into those.
[ 28. January 2008, 08:24 PM: Message edited by: chicago_bird ]
Posts: 69 | From Chicago, IL | Registered: May 2006
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
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the links I previously posted mostly are concerned with herbal supplements. SAMe is not that. Still, if you copy and paste the previous links, they would be good to have on hand.
There has been extensive research on SAMe (though we don't know everything, of course). PubMed has over 2,000 abstracts. Some links below.
I tried it years ago for energy and brain fog - before I knew about lyme being the underlying problem. SAMe had me flying around the room or, rather felt "wired" and tingling - not good for me at that time.
My adrenals may not have had the support for any more energy or other considerations. I was very ill and severely depleted then, so that must be a consideration. Is the body getting all the nutrients needed? I was not at that time.
Below are some statements about some populations not having enough and ATP, and all that. ATP is an wide field of study in regards to CFS and lyme. But I don't quite get it and don't have the energy to ferret it all out. Some compelling reasons to study it, though. It may be time for me to look at this again.
It makes sense that if our bodies need it and our bodies don't make enough, that supplementation might actually be needed. I don't know how you would do a test to know.
Attention to B-vitamins, starting slow and taking it early in day seems important.
Malic acid, magnesium or other things that help ATP and the amino acid methionine might be another way to have our livers make what they need of this. Just a thought, though. Not sure.
S-Adenosyl methionine, Clonazepam - No items found.
Clonazepam, liver - 72 abstracts
Clonazepam, NMDA - 32 abstracts
Clonazepam, GABA - 728 abstracts
To use "SAMe" for search, the computer brings you everything with the word ``same'' in it.
From what I know of klonopin, it is a CNS depressant. SAMe has opposite action though as secondary, not primary action.
If a perfect balance of day SAMe and night klonopin could be achieved, that might be something to explore.
I don't know how they would get along or overlap in the body chemistry of the brain or the liver regarding time or function.
As klonopin is an anti-seizure drug, anyone taking it for that purpose should get expert medical advice.
Klonopin has been written about in CFS literature (by Paul Cheney, MD) as being protective of the brain by lowering the excitatory NMDA stuff and supporting the GABA calming receptors. It may be stress some liver functions (C P-450 detox pathway) so protective measures should be considered.
If SAMe is excitatory in terms of NMDA (I don't know) and if, in effect, it pushes the NMDA receptors, that would be an addition question. However, SAMe might give the body something it needs, thereby settling down the excitatory action that can be a result of depletion. Lots to read out there.
From wikipedia (with usual note that this is a place to begin, knowing that it is a public collection of work - nice charts and graphs and good layout with references.)
S-adenosyl methionine (SAM) is a coenzyme involved in methyl group transfers. SAM was first discovered in 1952.[1]
It is made from adenosine triphosphate (ATP) and methionine by methionine adenosyltransferase EC 2.5.1.6. Transmethylation, transsulfuration, and aminopropylation are the metabolic pathways that use SAM.
Although these anabolic reactions occur throughout the body, most SAM is produced and consumed in the liver.[1]
. . .
Therapeutic uses of SAM
In the United States, SAM is sold as a nutritional supplement under the marketing name SAM-e (also spelled SAME or SAMe; pronounced "sam ee").
SAM is also marketed under the Gumbaral, Samyr, Adomet, and Admethionine brand names. Some research has shown that taking SAM on a regular basis can help fight depression,[7][8][9] liver disease, and the pain of osteoarthritis.
Multiple clinical trials confirm benefits for depression, some liver conditions, and osteoarthritis. All other indications are not yet proven.
. . . An emerging line of evidence suggests that abnormally low levels of endogenous SAM may play an important role in the development of Alzheimer's disease (AD) and that SAM may therefore have therapeutic potential in the treatment of AD.
Severely low levels of SAM have been found in the cerebrospinal fluid [10] and in all brain regions of AD patients examined.[11]
Preliminary research suggests SAM may have therapeutic potential in treating AD patients [12] and a recent study using a mouse model of AD found that supplementary SAM prevented oxidative damage and cognitive impairment.[13]
In that study (available online), Tchantchou et al also explain the biomechanics that in addition to the above findings make low SAM a likely causal component of AD pathology.
. . .
Possible side effects
SAM-e & Homocysteine: Once SAM-e donates its methyl group to choline, creatine, carnitine, DNA, tRNA, norepinephrine, and other compounds, it is transformed into S-adenosyl-homocysteine, (SAH).
Under normal circumstances, homocysteine, in the presence of Vitamin B6, B12, and folic acid (SAM-e's main co-factors), will eventually be converted back into methionine, SAM-e, or cysteine, glutathione, and other useful substances.
However, if adequate amounts of these vitamins are not present, SAM-e will not break down properly. As a consequence, the full benefits of SAM-e will not be obtained, and homocysteine may increase to unsafe levels.
High levels of homocysteine have been associated with atherosclerosis (hardening and narrowing of the arteries), as well as an increased risk of heart attacks, strokes, liver damage, and possibly Alzheimer's disease.
Therefore, Vitamin B supplements are often taken along with SAM-e. These vitamins help metabolize the homocysteine into other useful compounds. [1][20]
Another reported side effect of SAMe is insomnia, therefore the supplement is often taken in the morning.[19]
Other reports of mild side effects include lack of appetite, constipation, nausea, dry mouth, sweating, and anxiety/nervousness, but in placebo-controlled studies these side effects occur at about the same incidence in the placebo groups.
Therapeutic doses range from 400 mg/day to 1600 mg/day, although higher doses are used in some cases.[14][21] Consult with your physician before and during use.
DEPRESSION - Preliminary research suggests that SAMe is more effective than placebo in treating mild to moderate depression and is just as effective as anti-depressant medications without the side affects frequently associated with the medications (headaches, sleeplessness and sexual dysfunction).
Plus, antidepressants tend to take six to eight weeks to begin working, while SAMe seems to begin much more quickly than that.
. . .
OSTEOARTHRITIS - Laboratory and animal studies suggest that SAMe may reduce pain and inflammation in the joints as well as promote cartilage repair, but researchers are not clear about how or why this works. . . . Several of the studies also suggest that SAMe has fewer side effects than NSAIDs.
FIBROMYALGIA - From studies comparing SAMe to placebo, this supplement seems to improve pain, fatigue, morning stiffness, and mood in those with fibromyalgia.
LIVER DISEASE - Results of several animal studies suggest that SAMe may be beneficial in treating various liver disorders, particularly liver damage caused by excessive alcohol consumption.
Animal studies also suggest that SAMe may protect the liver from damage after acetaminophen overdose (a pain-relieving medication purchased without a prescription).
A study of 123 men and women with alcoholic liver cirrhosis (liver failure) found that SAMe treatment for 2 years may improve survival rates and delay the need for liver transplants more effectively than placebo. . . .
ALZHEIMER'S DISEASE - Studies suggest that people with Alzheimer's disease (AD) have low levels of SAMe in the brain and that supplementation can actually increase those levels. . . .
OTHER - Although it is premature to tell if these are safe or appropriate uses for SAMe, some early research has looked at the relationship between SAMe and Parkinson's disease, migraine headaches, Sjogrens disorder (which causes pain in connective tissue), attention deficit/hyperactivity disorder (ADHD) in adults, and vascular disorders such as heart disease.
SAMe levels may be low in people with Parkinson's and heart disease. However, experiments in rats have indicated that SAMe supplements may actually cause Parkinson's disease in these animals.
Given SAMe's structure, some have raised concern about the potential for SAMe to increase homocysteine levels. (Homocysteine has been shown to contribute to the development of plaques in the blood vessels).
However, early information suggests that SAMe may actually lower homocysteine. Research is needed to know whether taking SAMe supplements may reduce homocysteine and reduce one's chances of getting heart disease.
A preliminary study of 124 migraine sufferers suggests that SAMe may decrease the frequency, intensity, and duration of headaches as well as lead to an improved sense of well being and use of fewer pain killers.
DIETARY SOURCES - SAMe is not found in food.
It is produced by the body from ATP and the amino acid methionine.
(ATP serves as the cell's major energy source and drives a number of biological processes including muscle contraction and the production of protein).
HOW TO TAKE IT - . . . People with bipolar disorder (manic-depression) should not take SAMe since it may worsen manic episodes.
SAMe should not be combined with different antidepressants without first consulting a health care provider. People taking SAMe should supplement its use with a multivitamin that contains folic acid and vitamins B12 and B6.
Review Date: 4/1/2002
- full article at link above, with references
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[ 28. January 2008, 11:28 PM: Message edited by: Keebler ]
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