Milk Thistle and Prozac

I think herbalists are wonderful. Theirs is a discipline based on thousands of years of botanical knowledge and empirical observations. It is homeopaths whom I think are quacks.

One danger of herbal remedies, though, is that few medical trials have been conducted into their contraindications with prescription drugs; coupled with a common belief that anything picked from the ground is only beneficial (which I blame on militant veggies in the same way I blame traitors working with East German or Czechoslovakian intelligence for corrupting the Western Left). Yet, when something as innocuous as cranberry juice can lead to fatal hemorrhaging when consumed with warfarin, all is not as it seems.

With only the whole Internet reading… okay… with only the whole Internet *potentially* reading, I suffer from moderate clinical depression which has been exacerbated recent by recurrent migraines; and I have recently returned to the drug of choice, fluoxetine (aka prozac). I am also one for nuts and seeds and fruit teas; recently I sampled milk thistle.

180px-Silybum_marianum

Silybum marianum is a thistle which grows in temperate zones across the Northern Hemisphere, and extract from its seeds has been reported for centuries as a remedy against bilious feelings. I do not have any Athens or Shibboleth access just now, so can find only abstracts such as by Tamayo and Diamond (2003) of literature reviews of clinical trials into the medicinal properties of milk thistle. From what I can glean, it contains numerous phytochemicals which have are thought to have a palliative and restorative effect against liver ailments such as Hepititis C or HIV infection (or, as over-the-counter concoctions claim, hangovers).

The danger of taking the herbal mood-lifter hypericum (a.k.a. St John’s Wort) with SSRIs such as fluoxetine and sertraline is established. As a point, the promotion of hypericum regardless of prescription drugs was more likely an unfortunate coincidence than recklessness: its popularity began in Germany, where prescription anti-depressants were less common. I cannot, however, find much on milk thistle and SSRIs, although I noticed immediately intense pressure headaches as well as mild sweating and a slight tremble.

If anyone reading has more information, I would be grateful to see it. It goes without saying, I have stopped taking milk thistle.

Further Reading: SUVARNA R., PIRMOHAMED M., HENDERSON L. (2003) Possible Interactions Between Warfarin and Cranberry Juice British Medical Journal 327 1454

TAMAYO C, DIAMOND S. (2007) Review of Clinical Trials Evaluating Safety and Efficacy of Milk Thistle (Silybum marianum [L.] Gaertn.) Intergrative Cancer Therapies 6 2 146-57

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2 Responses to “Milk Thistle and Prozac”

  1. anonimous Says:

    I have been using milk thistle for app 2 weeks while also being on fluoxetine. I am experiencing major anxiety attacks again for the first time in 7 years. It feels like the ssri just stopped working or something. Also, during my last migraine attack the maxalt didn’t really seem to work either. It could be a coincidence, but I am definetely not ever going back to using milk thistle. It really feels like I suddenly stopped using fluoxetine. Now I am slowly upping my dose.

    • efrafandays Says:

      Thank you for that. Herbalism is emerging as a scientific discipline in its own right (unlike homeopathic method, no matter how much a certain Nobel Laureate in Medicine may claim), but there’re still big gaps in the knowledge: my doctor, for instance, didn’t know about milk thistle fullstop.

      It definitely sound as if there are cross-overs in the metabolic pathways in the liver, so we’re well advice to stop.

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