today I want to detail my experiences with Antidepressants. Since I am not a big fan or big pharma companies I chose to ask my doctor for Tryptophan first. And later for St. John’s wort. I have covered tryptophan here: https://rootlessintrospection.wordpress.com/2015/01/24/tryptophan-supplementation-to-medicate-depression/
– tryptophan is taken 4 days a week for 3 weeks during the builtup phase
– after that 2 days a week should be trypto days
– 1.5g to 3g each trypto day
– take it as soon as you wake up
– if you take it after 2pm or if you want to maximise effect: wait 30 mins after intake, then be
physically active (take a walk, work out, vacuum, do laundry…)
– do not eat until 2 hours after you have taken tryptophan
– tryptophan develops its antidepressant effect very fast
Now for St Johns Wort: it is a plant with a nice looking flower originating in Europe but has since spread all the way to china. Scientists gave it the name of Hypericum perforatum to make sure you don’t know what they are talking about. No one knows exactly how this plant has antidepressive effects but it does. And many people are much better of for it.
I’m barely two weeks into the St. John’s Wort treatment and this medication, like many antidepressiva, takes weeks to fully establish it’s effect on the patient. It’s sold as pills and my dosage for now is 300mg 3x a day totalling in 900mg a day. What I can say so far is that you absolutely should eat at least a little when you take your happy pill(s). I have vomitted once when I didn’t eat before. (I intended to have breakfast after shower, I got nauseous in the shower and didn’t feel much like breakfast for a while after this… But in the grand scheme of things, I’ll take one missed breakfast over Churchills Black Dog of Depression) Other side effects I experienced were a minimally more liquid stool (no diarrhea) and possibly decrease in libido.
But St. John’s wort seems well on its way to perform a miracle! I have had sleeping issues for 16 years. Mostly a delayed or even severely delayed sleep phase, rarely asleep before 3am. Now I fall sleep before 3 am consistent, sometimes even before midnight! Unheard of! I’m both thankful and confused what to do at 8 am in the morning 😀
Update 24th jan 2015: I now take 1200mg of St. John’s wort each morning and it still works wonders on my sleep rhythm!
The main issue why I want to write this post is this: St. John’s wort may or may not do well with other antidepressants. I have used tryptophan as an antidepressant directly before St. John’s Wort and did not have any depressive attacks were I could think of nothing but miserable things. I got used to the lack of energy over the years of my depression and understand they won’t fully go away until I find a therapist I can work with and all that but such bouts really get to me, especially now that I understand this is not normal.
So when I started taking St. John’s Wort I stopped tryptophan completely because they are said to not go well together. After more than a week of St. John’s Wort the plant obviously did not have much effect on my mental illness yet but the effects of tryptophan stopped by then. Because unlike most antidepressants, the antidepressive effect of tryptophan is reached very fast. One should think about days instead of the weeks it normally takes.
Knowing that tryptophan is an antidepressant with an unusually short span from intake to effect I considered briefly comedicating. I tried to research on the internet what to do. (I’m a scholar so I didn’t consider Yahoo Answers all that much 😛 ) which lead to no clear results. All pages seemed to agree it’s not a good idea to combine St. John’s wort with tryptophan, but no one said why or linked any studies. I felt very much on uncharted territory and on my own. But since the depressive bout got worse I felt up to an experiment. I have to be very clear here: seek medical advice when you do such things! Be aware of the risks and make absolutely sure this won’t have negative long term effects. This is in general very very dangerous.
my personal experiences with tryptophan and Hypericum comedication
First of all precautions: know what might happen. Research far and wide. Personally I did not only use my extensive scientific knowledge and ability to mine databases and understand sciency language but I was also aided by a person from the medical field giving me advice. Since we concluded we came up with nothing tangible and only guesswork we tried to extrapolate from incomplete data to find the worst case scenario of comedication: our candidate was serotonin syndrome.
The reason why the brain has extensive protective mechanisms in place and is so paranoid is that things can easily go wrong. Such as when you have too much serotonin in your brain. Normally this results “only” in hysterical unstoppable laughter but it could also end deadly. Since St. John’s Wort seems to interact with the serotonin system and tryptophan increases serotonin levels we are threading on thin ice here. Another potential effect of comedication is that side effects of either medication might be stronger than before or side effects known for these two medications might start to appear. So checking and double checking what I’m up against it came down to this: are my depressive bouts bad enough and threatening enough to my health to risk other side effects? I decided that they were as I did not want to see if suicidal thoughts would start to appear. I was bordering there already and wanted to be proactive. Also at that present moment I had other temporary medical problems which kept me from taking other preventing measures such as sport or meditation without negative side effects. So there breathe in breathe out, decision made.
Now how do we proceed? Obviously in the very most cases the magnitude of side effects is proportional to the dosage of medication. Since St. John’s Wort is a slow effect antidepressant I did not want to tamper with the dosage in general. But I purposefully changed my intake time the day before and on the day of tryptophan intake.
I intended to take tryptophan after waking up as usual so the day before I planned to take tryptophan I shifted my intake of St. John’s Wort to two 300mg pills at breakfast and one 300mg pill at lunch(bear in mind my breakfasts and lunches are much later than other peoples meal because of my shifted sleep patterns).
On the big day I shifted St. John’s wort intake times again. This time I took 300mg with my lunch and 600mg (twp pills) with my dinner. So by taking it early one day and late the day afterwards the concentration would be as normal until after the second morning. During the second day the concentration would fall a little bit. For long term medication this is usually not that big of an issue because by regularly taking them you should have a somewhat stable amount in your body at all times. But I wanted this little hick up. Because on the second morning I’d use tryptophan comedication.
Now the trickier part was how much tryptophan to take. Thankfully I already knew my reaction to the amino acids well from my previous time of medicating tryptophan alone. Thus I knew that even in robust circumstances (i.e. no other complicating substance in my system) more than 1g tryptophan was not advisable even if according to literature 1g is too low a dosage to counteract depression. In my case 1g was the ideal dosage before. Now years ago I have suffered combined side effects from unadvantageous combination of medication for mental health related issues. Back then I was not not allowed to see the respective instruction leaflets and the internet was no place to go to for information. I’m lucky I survived back then and I wasn’t going to throw this away by doing this recklessly, knowingly and under my own direction. So I decided to only take half of the dosage that was previously my optimum. 500mg. My idea was that I was more sensitive to it because of St. John’s Worts increasing effect on my system.
While not at full effect St. John’s Wort was clearly already changing things, doing little tweaks here and there to establish a new system of how my brain should run to not be depressed. I also thought about physical activity to augment the effectiveness of tryptophan. Here I felt I might even lack a choice. I was still sleep rhythm challenged in a big way. So it was within the realm of possibilities that I woke up late enough to need to move to keep tryptophan from being turned into melatonin. (Expplained in the tryptophan post I linked in the beginning of this post).
I resolved if I was lucky enough to wake up before 2pm I would purposefully not move. The idea behind this was the following: normally you want to move to achieve maximum effectiveness of tryptophan. But in my situation maximum effectiveness might lead to over the top side effects. So better not maximise. With tryptophan the biggest part of the battle is won with taking it on an empty stomach already, not moving only decides how high you are winning. As it turns out I woke up at 1:40pm. Yay 🙂 A small miracle and I won’t thank any deity for it. So I managed to eat this cake without the icing.
My initial plan was to see how this one day goes and take it from there. Such as :
1. it takes effect with manageable side effects -> then wait until im depressed enough again to repeat the treatment
2. it takes effect but the side effects are brutal -> wait until im very very very very bad off before I do it again, as the benefits of the treatment then need to outweigh the side effects and the bad depressive episode I initially want to to such experimental treatment in first place
3. it doesn’t take effect and I have no or little side effects -> wait a day and repeat with more tryptophan
4. it doesn’t take effect and the side effects are brutal -> the treatment is clear not an option at all
As it turns out I only had to battle an almost diarrhoea and it was working. Phew, I’m alive and kicking! And not as depressed as I could be! 🙂 All in all the tryptophan dosage could possibly be reduced even further. But the fun thing is that’s been a while ago now. The diarrhoea is long gone but the worst depressive episode have not returned. I still struggle with motivation but I hope St. John’s Wort will help me there in time. (Update 28th of April 2015: yes it did.) My motivation is currently not at a level where I feel the need to experiment any further. I manage to grocery shop, prepare meals and do some administrative tasks and even write a lengthy blog post on my experiences. All else can wait.
A word of caution in the end:
These are only my personal experiences with comedication. I wanted to make them public because I could not find any tangible information at all. It is very likely that someone else trying the same thing experiences different effects, maybe even much more dangerous than what happened to me. Hence medications need to be tested on thousands of individuals before they are commercially available. All I am providing is one personal experience. If you consider something like this read the precautions and ramification I took VERY seriously. Especially the part about doing your reasearch on how each of the two drugs works and how this might have VERY SERIOUS health effects that should be worth the gamble and all the precautions I named to reduce the potential problems. There was a happy end for me but this does absolutely not ensure one for you.
– St. John’s wort seems to be a good antidepressant which takes some weeks to build up its effects but I need to take it longer to see how it works in the long run
– Tryptophan works as an antidepressant for me and much faster than St. John’s wort does but sticking to the rules of how to take it might be too much for most depressed people
– Comedication with 500mg tryptophan once did not lead to extreme side effects in my case but prevented depressive episodes from happening again in my case
– be cautious when attempting to comedication with St. John’s wort! My report is in no way meant to be repesentative!