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ADs and alternative supplements etc

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Here in the UK there is a lot of 'talk' about the need to take supplements particularly omega 3 and 6 fish oils; flax seeds; magnesium.  All these seem to be aimed at preventing aches and pains in older age.

However, some practitioners are warning that the above might interfere with the prescribed medications such as anti-depressants to a dangerous degree.

Aged 50 I am now looking towards preventative health care.  I was considering fish oils to help ward off arthritic conditions.  I already use magnesium 3 times a week to help relax muscles which has stopped my irritating cough.  Flax is good for menobabes.  

Does anyone have the definative answer to 'yes' or 'no' for supplements?  I know that St Johns Wort is shown to interact with ADs.  Any info appreciated - thanks. :wave:

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Not an MD here, but my MD and Psych both have said that using fish oil in conjunction with A/D's is fine.  Its basically the same thing as eating mass amounts of fish.  St. Johns is a bit different in that it is an SSRI.  Combining it with other SSRI's may have some contraindictions.  My Psych highly recommended checking out the fish oil though, and I have decided to do so.  I've heard great things about the oil, and there are basically no side effects.  So why not try it?

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Fish oil has Omega-3 fatty acids and other compounds that may help with mood disorders, as well as possible anti-aging and general health benefits <she says with open-minded skepticism>


Glucosamine is now a well-documented anti-arthritis supplement, and has minimal interactions or side-effects.

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  • 3 weeks later...

St Johns Wort increases Serotonin, Norepinephrine and Dopamine.

I was really "anti-med" for 3 years, but when I started Prozac I finally knew what being "happy" felt like. I cried that day. The fact that I felt like garbage for many years (probably my whole life) was because I was being a stubborn fool. A few months later I lost 50 pounds, made lots of friends and got my act together in school.

I'll give you a example on how bad things were; after things started getting better, I talked on the phone to a person that was not a member of my family FOR THE FIRST TIME! I was 19!

All those

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Glucosamine  is a great suppliment lizzy for keeping joints and what not healthy.  it is what they give to race horses. lol.  i am serious! So if you have arthritis, it might be worth looking into. It helps to build up and maintain the cartledge and tendons.  Kind of like adding a protective coating.

People who take this also tend to take MSM as well as they find it helpful as well in combatting their arthritic pain. MSM is helpful in reducing pain, muscle spasms and inflamation as well.


*By the way, I dont take this stuff, I just know about it*  :;):

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I would say as a general rule that you should check the substance and dose with your doctor.  Taking a basic multivitamin is always a good idea and you can always add to it.  B vitamins are important for stress and moods and are water soluble making it impossible to take too much.  Magnesium is a good mineral and I will leave the explanation to Lizzy.  Omega 3 fatty acids especially EPA and DHA, the fish oils have become popular for mood disorders in patients on medication.  There have been a few good books on the subject out recently.  I would never use herbs, because they can really mess you up.  I try to always scan labels on energy bars and foods, because they sometimes toss a few herbs in there.  As for these pills that are supposedly a unique blend of 12 unknown substances that do something really magical in a short period of time I think they are a scam.  These pills have no place in the medicine cabinet of someone suffering from a serious illness.  Other than that communication with the doc, research, and careful monitoring are key to using alternative therapies with medication.

Katie :hearts:

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I was just wondering because it was my understanding that you could take magnesium daily. So i was wondering why Lizzy only takes it three times a week as opposed to daily.  ???

I could be way off on this though as I have a limited knowledege of magnesium though.

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You can take magnesium daily.  Usually you take it in the morning whereas you would take calcium at night.  Magnesium sometimes gets overlooked because there is such an emphasis on calcium.  Calcium and Magnesium are kind of grouped together because they balnce eac other.  If you have an excess of Calcium you can cause a deficit in Magnesium.  It is recommended that you get about 320 mgs daily if you are a woman.  Some food sources are whole grains, brocoli, potatoes, squash, beans, nuts, and seeds.  Coffee and chocolate contain small amounts of the mineral.  It sounds like Lizzy is taking it as a natural muscle relaxant.  It has a lot of other uses including the treatment of PMS.

Katie :O

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I take magnesium, despite not knowing much about it. And i take mine daily. That is why I was curious as to why Lizzy takes hers only three times a week.

Magnesium has also been shown to help ease migraines and nausea in addition to muscle tension. All things I get so that is why I take it.

I knew about the foods that contained it already but thanks for posting that info for others to read.  I am just curious as to Lizzy's three time a week use, unless she is just using it as a muscle relaxant as needed.  :)

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I would say as a general rule that you should check the substance and dose with your doctor

Good reminder, Katie!

I'm a big believer in OTC supplements, but always let your doc know what, when and how much you're taking. They can interact with prescribed meds. I check with my pharmacist, too, before I add anything new to my mix.

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  • 2 weeks later...

BTW, Lizard I was interested in what kind of OTC supplements you take.  You really do have to be careful with foods these days.  There are so many drinks out there that contain certain substances that people take as supplements.  Glaceau's line of Vitamin waters feature drinks like focus, stress-b, power-c, endurance, and multivitamin that contain ginseng and other herbs in addition to the vitamins.  You really do have to read the fine print.

Katie :;):

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Possible Interactions with: Omega-3 Fatty Acids

If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements without first talking to your healthcare provider.

Blood-thinning Medications

Omega-3 fatty acids may increase the blood-thinning effects of aspirin or warfarin. While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as heart disease), they should only be taken together under the guidance and supervision of your healthcare provider.


Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side effects (such as high blood pressure and kidney damage) associated with this medication in transplant patients.

Etretinate and Topical Steroids

The addition of omega-3 fatty acids (specifically EPA) to a drug regimen of etretinate and topical corticosteroids may improve symptoms of psoriasis.

Cholesterol-lowering Medications

Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as "statins" (such as atorvastatin, lovastatin, and simvastatin) to work more effectively.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.


Drug Interactions

Blood-thinning Medications


Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Topical Corticosteroids

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FDA on St John's Wort ~Forum Admin

St. John's Wort drug interactions (FDA report)

See table below for specific drugs to avoid if taking SJW

Natural source of purported antidepressants causes body to accelerate elimination of many therapeutic drugs: St. John's wort drug interactions can be severe and dangerous; St. Johns wort recall in Europe is not followed by FDA recall of St. John's wort. Update: 10 Feb 2003

St. John's wort (Hypericum perforatum)

Drug names

OTC for mild depression; questionable efficacy

Medical usage

Reduces efficacy of many other drugs which may be taken concurrently

Adverse effects

Multiple manufacturers, distributors, and retailers


Loss of efficacy of specific drugs taken

Patient presentation


Litigation status

Contact Info@DrugIntel.com

Further info

In February 2000 a "Dear Health Care Provider" letter was issued by FDA, indicating the worrisome effect of St. John's wort to cause an increase in the Cytochrome P450 enzymes (esp. CYP 3A4) which are responsible for the metabolism and elimination of many drugs. St. John's Wort is also an inhibitor of CYP 2D6. Hence patients taking St. John's wort likely are causing a reduction in blood levels of therapeutic drugs that they are taking for other purposes. Specific drugs noted include protease inhibitors for HIV, cancer chemotherapeutic drugs, and birth control drugs.

The American Medical Association has also sounded a loud note of caution concerning St. John's wort (JAMA Vol. 283 No. 13,April 5, 2000).

Implications for attorneys are three-fold:

* St. John's wort Merchants as Defendant: Cases of patients using St. Johns wort who failed to receive therapeutic benefits with prescribed or OTC drugs may target the providers of St. John's wort as negligent if inadequate warnings were given. Those providers include the manufacturers, packagers, distributors, and retail stores carrying this nutraceutical.

* Mitigating circumstance to defendant of other drug litigations: Cases of patients using who are involved in litigation concerning any drug must take St. John's wort use into account, either concerning loss of therapeutic action or production of side effects. For instance, a patient using Baycol and St. John's wort who suffers rhabdomyolysis could theoretically suffer worse side effects but less beneficial effect (causing physician to raise dosage). This could reduce the liability of the Baycol sponsor. A specific subset of prescription drugs is vulnerable.

* Additional warnings expected of defendant in other drug litigations: Cases of patients using drugs which do not include warnings for St. John's wort under drug interactions in their label and package insert. This sort of warning can be expected to be required for a specific subset of prescription drugs.

The vulnerable drugs include some of the following therapeutic categories:

Heart disease (including antihypertensives and calcium channel blockers)

Anti-epileptic drugs

Common anti-cancer drugs

Anti-rejection drugs used in transplants

Birth control drugs

Specific drugs contraindicated with St. John's Wort include:

carbamazepine (Tegretol) x St. John's Wort

citalopram (Celexa) x St. John's Wort

cyclosporin (Sandimmune, Neoral) x St. John's Wort

digoxin (Lanoxin) x St. John's Wort

fluoxetine (Prozac) x St. John's Wort

fluvoxamine (Luvox) x St. John's Wort

naratriptan (Amerge) x St. John's Wort

Oral Contraceptives x St. John's Wort

paroxetine (Paxil) x St. John's Wort

phenobarbital (Luminal)

phenytoin (Dilantin) x St. John's Wort

rizatriptan (Maxalt) x St. John's Wort

sertraline (Zoloft) x St. John's Wort

sumatriptan (Imitrex) x St. John's Wort

theophylline (Theo-Dur and many others) x St. John's Wort

warfarin (Coumadin) x St. John's Wort

zolmitriptan (Zomig) x St. John's Wort

United Kingdom

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