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Modafinil And St John's Wort


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#1 dreamstime

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Posted 14 October 2012 - 07:47 AM

Hi, I wondered if anyone has any experience with taking Modafinil and St John's Wort together?

I have mild depression (which I've suffered from off and on my whole adult life) and really want to do something about it, but after a disastrous experience with imiprimine for cataplexy I don't want to take conventional anti-depressants. I have fairly mild symptoms of EDS and my cataplexy is well-controlled without medication. Internet research suggests that St John's Wort may speed up the absorbtion of Provigil, but doesn't seem definitive. I take 100-200mg of Provigil a day and don't really want to increase my dose.

Of course I wouldn't think of changing my medication without asking my doctor. He couldn't tell me anything I hadn't read about and said "well, you can give it a go if you want." (He has in the past cheerily told me "you're the expert!" about my own narcolepsy, which is rather accurate but not exactly encouraging.)

Any thoughts on this would be appreciated. Thanks in advance!

#2 Megssosleepy

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Posted 15 October 2012 - 02:49 PM

Hi, I wondered if anyone has any experience with taking Modafinil and St John's Wort together?

I have mild depression (which I've suffered from off and on my whole adult life) and really want to do something about it, but after a disastrous experience with imiprimine for cataplexy I don't want to take conventional anti-depressants. I have fairly mild symptoms of EDS and my cataplexy is well-controlled without medication. Internet research suggests that St John's Wort may speed up the absorbtion of Provigil, but doesn't seem definitive. I take 100-200mg of Provigil a day and don't really want to increase my dose.

Of course I wouldn't think of changing my medication without asking my doctor. He couldn't tell me anything I hadn't read about and said "well, you can give it a go if you want." (He has in the past cheerily told me "you're the expert!" about my own narcolepsy, which is rather accurate but not exactly encouraging.)

Any thoughts on this would be appreciated. Thanks in advance!


I have read many many many places about st. Johns... read a German study that had 3 groups... placebo, Prozac, and st. John... the Prozac and St. Johns score equally in feeling better!

I will be trying it very soon! along with some other items that I have done a fair amount of research on... I know there was a warning in one of my books not to take it if you are already taking an SSRI... I am still waiting for the Prozac to be out of my system... since provig. is not an anti-depressant, I think (I am not a doc) it would be safe to try! Just use as directed... also there are some other nutrients to up the absorption of St. John... I don't have the info in front of me but will try to remember to look when I get home. You would be surprised how many natural and safe substitutions are out there!

#3 Hank

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Posted 15 October 2012 - 08:57 PM

http://reference.med...eractionchecker

Looks like St. Johns Wart and Provigil is ok. But it is not ok with Adderall. If I am able to get by without Adderall for longer than a weekend, I might like to try it.

#4 LauraL

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Posted 15 October 2012 - 09:49 PM

The active ingredient in St. John's Wort is actually a monoamine oxidase inhibitor (MAOI), which is an older class of antidepressants. My understanding is that, in general, selective serotonin reuptake inhibitors (SSRIs) and SNRIs are preferred to MAOIs because there are fewer side effects and fewer possibilities of drug interaction. But a good pharmacist would be able to tell you more about this. In general, I don't like the idea of taking supplements like this one. I mean, vitamins are one thing, but the active component in St. John's Wort is as much a drug as any pharmaceutical product. However, since it's a supplement, it's not as tightly regulated as a drug. Which means that you really have no way of knowing from one batch to the next how potent the stuff is. Pharmaceuticals, on the other hand, are manufactured to very exacting standards, so you're sure to reliably get the same dose time after time. Besides that, since MAOIs are known to have so many interactions, even with certain kinds of foods!, I think I'd avoid them if I could find something else that worked.

And, BTW, no, modafinil is not an antidepressant, but it does affect the same neurotransmitters as some antidepressants (norepinepherine), so you'll definitely want to check on that with a pharmacist or doctor. For a while I was on a migraine medication that affected the serotonin pathway, and the pharmacist gave me a stern warning about watching for signs of serotonin syndrome, which apparently can be quite dangerous.

Have you ever tried an SSRI or SNRI (I think imipramine is a tricyclic, which also tend to have lots of interactions/side effects)? I also suffer from depression, and have taken several different SSRIs and SNRIs over the years, including in combination with Nuvigil. They've been quite effective for me. I can sympathize with not wanting to take medication for mild depression. I tried a variety of other non-medical things over the years to help with depression. Counseling was the main thing that helped. Yoga, meditation, walks--these were all helpful, too. Light therapy seems to be helpful for a lot of people, too, although it didn't do much for me. Unfortunately, they ultimately proved to not be enough for me. I was very hesitant to take the drug route, but my quality of life improved immensely, so I'm glad I did. If you did go that route, the one thing I cannot recommend highly enough is to work with a psychiatrist rather than just a primary care doctor on these types of medications. They have much more experience dosing them, and seem to have a better feel for which drug(s) will work best for which people.

Anyway, good luck. Depression is no picnic, that's for sure!

#5 DeathRabbit

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Posted 15 October 2012 - 10:25 PM

The active ingredient in St. John's Wort is actually a monoamine oxidase inhibitor (MAOI), which is an older class of antidepressants. My understanding is that, in general, selective serotonin reuptake inhibitors (SSRIs) and SNRIs are preferred to MAOIs because there are fewer side effects and fewer possibilities of drug interaction. But a good pharmacist would be able to tell you more about this. In general, I don't like the idea of taking supplements like this one. I mean, vitamins are one thing, but the active component in St. John's Wort is as much a drug as any pharmaceutical product. However, since it's a supplement, it's not as tightly regulated as a drug. Which means that you really have no way of knowing from one batch to the next how potent the stuff is. Pharmaceuticals, on the other hand, are manufactured to very exacting standards, so you're sure to reliably get the same dose time after time. Besides that, since MAOIs are known to have so many interactions, even with certain kinds of foods!, I think I'd avoid them if I could find something else that worked.

And, BTW, no, modafinil is not an antidepressant, but it does affect the same neurotransmitters as some antidepressants (norepinepherine), so you'll definitely want to check on that with a pharmacist or doctor. For a while I was on a migraine medication that affected the serotonin pathway, and the pharmacist gave me a stern warning about watching for signs of serotonin syndrome, which apparently can be quite dangerous.

Have you ever tried an SSRI or SNRI (I think imipramine is a tricyclic, which also tend to have lots of interactions/side effects)? I also suffer from depression, and have taken several different SSRIs and SNRIs over the years, including in combination with Nuvigil. They've been quite effective for me. I can sympathize with not wanting to take medication for mild depression. I tried a variety of other non-medical things over the years to help with depression. Counseling was the main thing that helped. Yoga, meditation, walks--these were all helpful, too. Light therapy seems to be helpful for a lot of people, too, although it didn't do much for me. Unfortunately, they ultimately proved to not be enough for me. I was very hesitant to take the drug route, but my quality of life improved immensely, so I'm glad I did. If you did go that route, the one thing I cannot recommend highly enough is to work with a psychiatrist rather than just a primary care doctor on these types of medications. They have much more experience dosing them, and seem to have a better feel for which drug(s) will work best for which people.

Anyway, good luck. Depression is no picnic, that's for sure!

Very nice. I agree. I'm not antagonistic toward supplements, but they do deserve caution. I still remember that metabolife stuff back in the 90s which turned out to be random crap in a pill riddled with carcinogens. Be careful and make sure you know what is up.

#6 Megssosleepy

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Posted 16 October 2012 - 12:19 PM

Have you ever tried an SSRI or SNRI (I think imipramine is a tricyclic, which also tend to have lots of interactions/side effects)? I also suffer from depression, and have taken several different SSRIs and SNRIs over the years, including in combination with Nuvigil. They've been quite effective for me. I can sympathize with not wanting to take medication for mild depression. I tried a variety of other non-medical things over the years to help with depression. Counseling was the main thing that helped. Yoga, meditation, walks--these were all helpful, too. Light therapy seems to be helpful for a lot of people, too, although it didn't do much for me. Unfortunately, they ultimately proved to not be enough for me. I was very hesitant to take the drug route, but my quality of life improved immensely, so I'm glad I did. If you did go that route, the one thing I cannot recommend highly enough is to work with a psychiatrist rather than just a primary care doctor on these types of medications. They have much more experience dosing them, and seem to have a better feel for which drug(s) will work best for which people.

Anyway, good luck. Depression is no picnic, that's for sure!


Thanks for your post, My light should be coming in the mail tomorrow! I am very excited! I was working with a Psychiatrist and she only pushed Prozac on me. Well, thanks to our friend Hank I discovered that the reason I was having so many more side effects then others was due to the interaction between the 3 drugs. The Psy, basically told me to take care of my sleep issues and then come back for the Prozac! (Not even going to get into that again)

When on adderall, xyrem, and prozac... I had 0 appetite, my stomach didn't even rumble when it was empty... putting food in my mouth was like trying to eat dirt. Off the Prozac I still don't really think about food, but when I start eating... I continue to eat rather then forcing myself to swallow! Getting food in my stomach has helped in so many areas!!!

Other side effects caused by Xyrem and Adderall were made so much worse when I also had Prozac in my system... unfortunitly the anxiety and depression keep rearing their ugly head, but its not the same as it was before treating my N. I hope that with continued improvement I will also see improvement in that area!

I guess the moral of the story is we really need to double check everything! EVEN when our docs say its safe, because some don't care enough to check first, and they don't like to be told they are wrong!

#7 wanttosleep1

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Posted 05 November 2012 - 10:31 AM

http://reference.med...eractionchecker

Looks like St. Johns Wart and Provigil is ok. But it is not ok with Adderall. If I am able to get by without Adderall for longer than a weekend, I might like to try it.



#8 wanttosleep1

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Posted 05 November 2012 - 10:32 AM

I have been taking Adderall and St. Johns wort for a long time. Hasn't bothered me. is this a bad thing?

#9 DeathRabbit

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Posted 05 November 2012 - 11:38 AM

I have been taking Adderall and St. Johns wort for a long time. Hasn't bothered me. is this a bad thing?

If it hasn't done anything by now, it won't. Honestly, those online drug interactions databases tend to be overzealous. I have medications that interact in triplicate, so technically both my arms and legs should have fallen off a few months ago, haha

#10 wanttosleep1

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Posted 05 November 2012 - 12:52 PM

If it hasn't done anything by now, it won't. Honestly, those online drug interactions databases tend to be overzealous. I have medications that interact in triplicate, so technically both my arms and legs should have fallen off a few months ago, haha


LOL. I know a few days ago and I had a big crying spell. I think it was a combination of hormonal changes, having been off my Adderall for a week and sleep deprivation. I tried Nuvigil for a week and it did NOT work. I am back on my Adderall. With winter coming up and the low light, I definitely need the St. John's Wort for reinforcement of a positive mood :rolleyes:

#11 dreamstime

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Posted 05 November 2012 - 04:11 PM

Thanks everyone for your replies. I did start taking St Johns Wort about 3 weeks ago and so far, so good. And no interaction with Modafinil that I can tell. I've tried a lot of things for depression over the years, including meditation, yoga and exercise. I know that counselling would be helpful but am unlikely to get that or a referral to a psychiatrist without a long wait on the national health system (I now live in the UK, though I'm American). I'm not doing any exercise at the moment and I think that would help--I just need to find free time when I'm not exhausted, which is not very often!! Also thanks for the reminder about light therapy, I might try that as my depression does seem to have some seasonal basis.

#12 sandygears

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Posted 25 November 2012 - 09:22 AM

St. John's Wort is amazing. I take the Solaray one-a-day 900 mg. I find it helpful to only have to take one a day, and this is the full amount to take per day.

Thanks everyone for your replies. I did start taking St Johns Wort about 3 weeks ago and so far, so good. And no interaction with Modafinil that I can tell. I've tried a lot of things for depression over the years, including meditation, yoga and exercise. I know that counselling would be helpful but am unlikely to get that or a referral to a psychiatrist without a long wait on the national health system (I now live in the UK, though I'm American). I'm not doing any exercise at the moment and I think that would help--I just need to find free time when I'm not exhausted, which is not very often!! Also thanks for the reminder about light therapy, I might try that as my depression does seem to have some seasonal basis.