hypericum and Hypertension

Antidepressants are commonly used drugs with potential for numerous drug interactions. This study aims to systematically review the literature on drug interactions with antidepressants.. We searched MEDLINE (1966 to November 2003) and EMBASE (1980 to 2003), using the heading drug interactions combined with individual antidepressant names. We restricted searches to English-language articles and human studies. We screened drug interaction texts and review articles for relevant studies. We included articles reporting original human data on drug interactions with antidepressants commonly used in North America. Articles were independently evaluated by 2 reviewers on clinical effect, clinical significance, and quality of evidence. Discrepancies were resolved by consensus.. There were 904 eligible interactions, involving 9509 patients, for a total of 598 summary interactions. Of these, 439 (73%) demonstrated an interaction, 148 (25%) had no effect, and 11 (2%) had conflicting evidence. For 510 interactions (85%), the quality of evidence was poor. It was fair for 67 (11%) interactions and good for 10 (2%) interactions. There were no interactions with excellent quality of evidence. There were 145 (24%) interactions of major clinical significance. These were predominantly hypertensive emergencies and serotonin syndrome. Most interacting drugs had central nervous system (CNS) activity. As expected, monoamine oxidase inhibitors (MAOIs) appear to be the most problematic family in terms of potential for serious drug interactions.. Drug interactions with antidepressants are an important cause for concern, but this concern is based primarily on poor evidence. We recommend caution when combining antidepressants with other CNS drugs, particularly when coadministering MAOIs with other substances.

Topics: Cytochrome P-450 Enzyme System; Depressive Disorder, Major; Drug Interactions; Drug Therapy; Drug-Related Side Effects and Adverse Reactions; Humans; Hypericum; Hypertension; Monoamine Oxidase Inhibitors; Phytotherapy; Selective Serotonin Reuptake Inhibitors; Serotonin Syndrome

The prevalence of herb-drug interactions has been exaggerated. Nonetheless, some herbs, including garlic, ginkgo, ginseng, and St John's wort, can have a significant influence on concurrently administered drugs. Herbal medicines may mimic, decrease, or increase the action of prescribed drugs. This can be especially important for drugs with narrow therapeutic windows and in sensitive patient populations such as older adults, the chronically ill, and those with compromised immune systems.

Topics: Anticoagulants; Cardiovascular Agents; Digoxin; Drug Interactions; Herb-Drug Interactions; Humans; Hypericum; Hypertension; Hypokalemia; Phytotherapy; Plant Preparations

The inhibitory effects of 22 xanthones from three Guttiferae plants (Hypericum patulum, Calophyllum inophyllum and C. austroindium) on exogenous platelet activating factor (PAF)-induced hypotension were examined using a blood pressure monitoring in vivo assay method. Guanandin (2), caloxanthone E (3), 1,3,5,6-tetrahydroxy-2-isoprenylxanthone (8), 6-deoxyjacareubin (11) and patulone (18) showed strong inhibition of PAF-induced hypotension, with inhibitory effects of more than 60 %. Their ID50 values were greater than that of ginkgolide B (BN-52 021), a natural PAF-antagonist from the Ginkgo biloba.

Topics: Animals; Antihypertensive Agents; Blood Pressure; Calophyllum; Hypericum; Hypertension; Male; Mice; Mice, Inbred Strains; Phytotherapy; Plant Extracts; Platelet Activating Factor

Topics: Humans; Hypericum; Hypertension; Male; Middle Aged; Plant Preparations; Stress, Psychological

Topics: Acute Disease; Adult; Antidepressive Agents; Cheese; Delirium; Food-Drug Interactions; Humans; Hypericum; Hypertension; Male; Monoamine Oxidase Inhibitors

Topics: Acute Disease; Adult; Anxiety; Emergency Treatment; Female; Humans; Hypericum; Hypertension; Nausea; Plants, Medicinal

Topics: Antihypertensive Agents; Diuretics; Heart Rate; Humans; Hypericum; Hypertension; Hypnotics and Sedatives; Orthosiphon; Plants; Pulse