Synthetic alternative to St John's Wort
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St John's Wort and Passionflower 400mg b.i.d put my depression into remission for around a year and a half. I remember weeping tears of joy when I began feeling a clarity of mind and depth of emotion I hadn't had in years after the herb reached full effect.
Recently I have had to start another medicine which significantly interacts with above and have gone to my GP to try two synthetic drugs so far. Sertraline 50mg sedated me to the point where I couldn't get out of bed, and fluoxetine at 20mg 'worked', while robbing me of all emotion and making me extremely sedated. Fluoxetine at 10mg had some antidepressant activity with little sedation, but nothing as effective as St John's Wort.
Now, on nothing, I am depressed to the point where it is genuinely painful. I've been prescribed venlafaxine to try this week. Reading that its NET inhibition is very mild I have doubts.
I'm irritated at my GP who won't prescribe bupropion because it isn't licenced for depression in Ireland despite carrying significant evidence. It seems reasonable to me that serotonin reuptake alone isn't enough to put my depression into remission, and SJW is understood to be a broad-spectrum reuptaker.
I'm genuinely peeved at the stupidity of the process. Having been on multiple meds now I can distinguish between low mood and depression. SJW treats both, fluoxetine only treats the latter. Both are awful but one isn't necessarily worse than the other. Bupropion from my research significantly raises mood, being an NDRI.
I'm peeved also at the medical industry which has two dozen SSRIs for every NRI/NDRI/SNDRI. Anhedonia, sedation and sexual stunting are widespread side effects of exclusive serotonin modulation, and pills from the 90s with very poor remission rates are still pushed as first-line medicines contrary to the burden of evidence.
ChatGPT tells me bupropion at 150mg o/d and fluoxetine/venlafaxine at standard or sub-standard dose might come close to mimicking SJW and I'm inclined to agree with it. This seems to be a reasonable and safe intervention but my GP won't agree to it because Irish antidepressant guidelines seem to be stupid and antiquated.
More of a rant than anything else, curious to read of anyone else's experience.