Posted by Sunnely on May 29, 2001, at 23:06:10
In reply to Birth Control Pill, Depression and St. John's Wort, posted by Cindylou on May 28, 2001, at 13:03:25
Hi Cindy,
There have been reports of oral contraceptives (OCs) inducing or aggravating depression.
I don't know for sure if OCs interfere with the action of St. John's wort (SJW). In fact, the exact mechanism as to how SJW acts as antidepressant remains unclear. OTOH, SJW can interfere with the metabolism of OCs. SJW has been found to be an "inducer" of a gut enzyme called CYP3A4. A number of OCs are metabolized by this enzyme. The combined use of SJW + OCs ---- > hasten metabolism of OCs ----- > increased OC clearance ----- > decreased OC blood level ----- > loss of OC effectiveness ----- > adverse reactions such as spotting, breakthrough bleeding, or unwanted pregrancy.
I am not sure if OCs interfere with the action of moclobemide (Manerix), a RIMA (reversible inhibitor of monoamine oxidase-A). Although there is a potential for the occurrence of serotonin syndrome with the MAOIs (irreversible type) if combined with SJW, this is probably unlikely with SJW + RIMAs.
++++++++++++++++++++++++
> Hi,
> I have a few questions regarding the birth control pill...
>
> 1. Can it CAUSE depression?
> 2. Can it HELP depression?
> 3. Can it interfere with the effects of St. John's Wort?
> 4. Can it interfere with effects of Manerix (an MAOI)?
>
> Thanks in advance for your responses.
>
> Quick background on me if you need it ...
>
> I have a long history of moderate depression, sometimes bordering on severe. Have been on AD meds for almost 12 years, mostly SSRIs plus Wellbutrin. Have since stopped all meds in order to "start fresh" since the SSRIs make me extremely fatigued. I am considering trying St. John's Wort -- I know it's only for mild depression, but my nutritionist is encouraging me to try it since she's seen it help moderate cases as well, and I am very petite with a fast metabolism. My other option is Manerix -- a reverible MAOI.
>
> I'm considering going on the Birth Control Pill, more for help with PMS than for birth control.
>
> Any information on all of this "stuff" would be greatly appreciated!!
>
> -cindy
poster:Sunnely
thread:64502
URL: http://www.dr-bob.org/babble/20010522/msgs/64682.html