St John's Wort Side Effects Please Help

Patient

Q: Following some periods of bad depression and severe peaks and troughs, I have been taking St John's Wort for about 2 years now. I find it really levels me out, makes me calmer more rational and just generally makes day to day life and stress easier to deal with.
I have decreased my dose to only one 300mg tablet. However, I have found that I have been unable to sleep, waking up at about 4am every morning and not being able to get back to sleep. This improved when I started taking my daily tablet first thing in the morning, but I am still waking up at around 5am. I have been taking various sleeping tablets but this has not worked. I am resigned to waking up at 5am every morning.
The other real problem is that when I take the St John's Wort tablet I get stomach pains, cramps and very bad wind, so much so that it becomes painful and uncomfortable. Having done some research I have found that this may be due to the tyramine in the food I am eating. It is particularly bad when I have been drinking beer. This is causing a real problem.
I don't feel that I can manage though without taking St John's Wort. I have just stopped taking it for a week and feel absolutely terrible; irritable, aggressive, depressed and anxious.
I have had therapy, and I don't really want to take anti depressants. What can I do?

Doctor

A:   This question is currently in queue and will be answered shortly by one of our doctors. In the meantime you may browse our library of answered questions by clicking here.

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