Q & A: Herbs and drugs to avoid while taking Luvox

by Richard Glickman-Simon, MD

Q: My physician recently prescribed Luvox to me while weaning me off of Paxil. There appear to be many herbs and drugs that cannot be taken with Luvox. Is this a real concern, and which herbs and drugs should I avoid?

A: The potential for interactions between medications and herbs is a very real and growing concern. About one in five people who use prescription drugs also take herbs or other dietary supplements. Since most prescribing physicians do not routinely ask patients about alternative therapies

Herbs and medications can adversely interact with each other in two main ways:

Altered metabolism. Once digested by the stomach and absorbed by the intestines, anything taken by mouth

Luvox is a selective-serotonin reuptake inhibitor (SSRI). This type of medication is thought to work by increasing the level of serotonin, a chemical messenger called a neurotransmitter, in the brain. Other SSRIs and similar serotonergic antidepressants include:

• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Nefazodone (Serzone)
• Trazodone (Desyrel)
• Venlafaxine (Effexor)

Combining these medications with herbs that have the potential to enhance serotonin activity can result in serotonin syndrome. This is a serious condition in which too much serotonin leads to symptoms of anxiety, restlessness, confusion, weakness, tremor, high fever, profuse sweating, and rapid heartbeat.

To avoid serotonin syndrome, the following substances should not be combined with Luvox or any other SSRI or similar anti-depressant:

• 5-hydroxytryptophan (5-HTP)