I’m in my late 40’s and have lifelong moderate depression plus have ED

Patient: I’m in my late 40’s and have lifelong moderate depression plus have ED and related issues from prostate removal 2 yrs ago due to cancer. I take welbutrin for the depression plus a couple OTC pills of st johns wort and a couple of 5HTP, also. I take quite a few herbal supplements, mostly in the form of bulk powders, for the ED etc and other minor health issues. I’m hoping to increase my intake of 5HTP once I receive a bulk powder order and hope this’ll allow me to stop taking the wort since it might make me photosensitive; I’ve experienced this before though that was when I was taking way more wort. Other than the welbutrin, I also take 2 prescription nasal sprays for dust allergy and have been getting immunotherapy shots for 3 yrs for this.I’ve read wort can interfere with certain meds and supplements; WHICH ones though, specifically?

Doctor: Hi.It is a bit shocking new for me to have cancer of the prostate at such an early age. You will definitely need all the medicines and have to suffer some problems inherent to this.Do not take the following medicines if you are taking WORT: antidepressant, amphetamines, blood thinners (eg, warfarin), bromocriptine, narcotic analgesics.Hence, it is important to consult your Psychiatrist as these can have all the adverse reactions about which only a Psychiatrist can help you out.Please consult a Psychiatrist for further care so that you will be not confused and get the most appropriate treatment.Hope this helps.

Comments / Follow Ups

Patient: I am aware of the risk of ‘serotonin syndrome’ where a person basically produces an ‘overdose amount’ amount due to too much intake of serotonin-producing meds and supplements. But I figure that so long as I’m careful too not take to much in combination of welbutrin and wort, and so long as i’m not experiencing any of the symptoms of SS (feelings of invincibility, or anything else unusual) then I should be fine. Is this not correct?? Please let me know.

Patient: Oh, and I should probably mention that to combat some OCD issues, I take a ton of fish oil: 8500mg of omega 3 per day. And I am aware of the risk of slow-clotting due to fish oil’s blood-thinning effect.