hypericum and Substance-Related-Disorders

Substance abuse and dependence is a serious problem throughout the world. The development of several types of dependence remedies has medical, social and economical significance. In particular, alcohol and tobacco are the most commonly abused substances worldwide. An extract of Hypericum perforatum L. (HPE) displayed a clear antidepressant action and it has been used for the treatment of mild to moderate depression. Recent reports imply that HPE may be effective in the treatment of substance abuse. Studies have focused on alcohol and nicotine dependence. In this review, the effects of HPE on substance dependence and its possible benefit have been discussed in the light of current literature.

Topics: Alcoholism; Animals; Humans; Hypericum; Plant Extracts; Smoking; Smoking Prevention; Substance Withdrawal Syndrome; Substance-Related Disorders

St. John's wort, a popular over-the-counter drug for treatment of depression, might reduce concentrations of drugs such as cyclosporin and indinavir and lead to drug resistance and treatment failure. No studies as yet have examined its influence on methadone plasma levels. The trough methadone plasma levels were measured in four patients (2 males, median age: 31 years; range 19 - 40 years) in methadone maintenance treatment just before the introduction of St. John's wort (900 mg/d) and after a median period of 31-day treatment (range 14 - 47). The study was proposed to addict patients about to start an antidepressant therapy. Introduction of St. John's wort resulted in a strong reduction of (R,S)-methadone concentration-to-dose ratios in the four median patients included, with a median decrease to 47 % of the original concentration (range: 19 % - 60 % of the original concentration). Two patients reported symptoms that suggested a withdrawal syndrome. Thus, prescription of St. John's wort might decrease methadone blood levels and induce withdrawal symptoms which, if not correctly identified and handled (by changing the antidepressant or by increasing the methadone dose), might cause unnecessary discomfort to the patient, lead to resumption of illicit drug uses, or be a risk factor for discontinuation of the methadone or antidepressant treatment.

Topics: Adult; Analgesics, Opioid; Depressive Disorder; Drug Interactions; Drug Therapy, Combination; Humans; Hypericum; Male; Methadone; Plant Preparations; Substance-Related Disorders

Topics: Benzodiazepines; Biological Availability; Craving; Humans; Hypericum; Male; Middle Aged; Plant Extracts; Substance Withdrawal Syndrome; Substance-Related Disorders; Tachycardia; Treatment Outcome; Tremor

St John's wort (Hypericum perforatum) has been known for centuries for its therapeutic properties and its efficacy as an antidepressant has been confirmed by a growing body of evidence. During the last two decades it has also come to prominence with a wider public, due to advertising efforts across Europe and United States of America. However, its availability without prescription, as an over-the-counter medication, raises some concern regarding its clinical management and unsupervised administration to individuals with psychopathological risks. To date, the evidence available regarding the administration of Hypericum in people with severe mental health problems is still meager and refers mainly to affective disorder spectrum or psychotic relapse in people with established diagnoses. To the best of our knowledge, this is the first report regarding the onset of psychotic features in a patient presenting with psychotic diathesis.. The case discussed in this report is a 25-year-old white man, not known to the psychiatric services, with a history of brief and self-remitting drug-induced psychosis and a positive family history of psychotic depression. He was admitted to hospital due to the onset of florid psychotic symptoms concomitant with self-administration of Hypericum perforatum.. The aim of this report is to promote further systematic research, draw the attention of clinicians to the potential risks of Hypericum precipitating psychosis, and raise awareness among health professionals to investigate and caution their patients on the haphazard use of phytotherapeutics such as Hypericum.

Topics: Adult; Antidepressive Agents; Depressive Disorder, Major; Helicobacter Infections; Humans; Hypericum; Male; Phytotherapy; Psychoses, Substance-Induced; Self Medication; Substance-Related Disorders

Herbal medicine is widely used by individuals with mental health problems, although research on their health characteristics and health care utilization patterns—including concomitant treatment with conventional mental health care and psychotropic medication—remains limited.. We gathered data from the National Comorbidity Survey Replication (NCS-R), a representative survey of US adults in which diagnoses of mental disorders were based on a fully structured diagnostic interview.. Our analysis found that NCS-R respondents with mental disorders were significantly more likely to have used herbal medicines for mental health problems than respondents who did not meet criteria for a mental disorder. Users of herbal medicines for mental health problems were likely to utilize conventional health care as well, particularly conventional psychiatric medication. Herbal use also was associated with having multiple comorbid medical problems.. A substantial proportion of US adults use herbal medicine to treat mental health problems. Herbal medicine is frequently used concomitantly with conventional health care, including prescription psychotropic medication. Herbal use also is associated with having multiple chronic medical problems. These factors increase the potential for interactions between herbal medicines and psychiatric and nonpsychiatric medications.

Topics: Adult; Alcohol Drinking; Comorbidity; Complementary Therapies; Drug Therapy, Combination; Drug Utilization; Female; Health Surveys; Humans; Hypericum; Male; Mental Disorders; Mental Health Services; Middle Aged; Phytotherapy; Psychotropic Drugs; Substance-Related Disorders; United States; Utilization Review