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Notes from September 26th

by: Meghan Shah

Notes from September 26th HORT 3440

Meghan Shah
GPA 3.78

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Anxiety St. John's-wort Kava
Herbs, Spices, and Medicinal Plants
James Affecter
Class Notes
25 ?




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This 4 page Class Notes was uploaded by Meghan Shah on Sunday October 16, 2016. The Class Notes belongs to HORT 3440 at University of Georgia taught by James Affecter in Fall 2016. Since its upload, it has received 2 views. For similar materials see Herbs, Spices, and Medicinal Plants in Biology/Anthropology at University of Georgia.

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Date Created: 10/16/16
Notes from Oct. 26 th  Valerian  ○ Valerian fam ○ Valeriana officinalis ○ Herbaceous perennial native to Europe and western Asia ○ Roots are used; they have a bad smell (rumored to have been used by the Pied  Piper) ○ Clinical studies support use as a mild tranquilizer (restlessness, stress, insomnia) ○ Efforts to isolate and identify the active principle(s) have been unsuccessful;  effect may depend on interaction of several chemical components  ○ Consumers sometimes confuse Valerian with Valium; they’re not related ○ Side effects: may cause excitability if too large a dose is taken ○ Does not potentiate alcohol, does not affect driving ability, does not produce  hangover ○ Scientists aren’t sure how Valerian works, but they believe it increases the  amount of a chemical called gamma aminobutyric acid (GABA) in the brain ○ GABA helps regulate nerve cells and has a calming effect on anxiety ○ Drugs such as alprazolam (Xanax) and diazepam (Valium) also work by  increasing the amount of GABA in the brain.  Researchers think valerian may  have a similar, but weaker effect ○ In horticulture, valerian plants are attractive perennials for the sun or partial  shade, has vanilla­scented flowers, and can go dormant in summer heat, reviving in fall.  Passion Flower ○ Passion Flower fam ○ Passiflora incarnate ○ Perennial vine native to southeastern US ○ Aerial shoots are used ○ Also known as Maypop  ○ Ornate flowers said to symbolize events of the crucifixion  ○ Introduced as medicine by a Mississippi MD in1840; now used in many OTC  preparations in Germany ○ Non­addictive tranquilizer for nervous unrest; reduces anxiety and induces sleep ○ Does not potentiate alcohol ○ Cautions: do not take with monoamine oxidase­inhibiting (MAO) antidepressants; contains uterine stimulants, so avoid during pregnancy ○ Blue Passionflower (P. caerulea), native to Brazil and Argentina, is often  cultivated, but contains cyanogenic glycosides, so do not confuse the two  species! ○ In horticulture, passionflowers are attractive vines when climbing a fence or a  lattice; edible fruit, “Maypop” refers to the sound the fruit makes when stomped  on the ground; propagate from cuttings or divisions  Kava ○ Pepper fam ○ Piper methysticum ○ Shrub native to the south Pacific region  ○ Root used  ○ Anxiety, stress, insomnia ○ 118 known cultivars in the south Pacific region ○ Important ceremonial drink, aphrodisiac ○ Western use has largely evolved in Germany ○ Kava lactones depress CNS, so do not use with other CNS depressants  (including alcohol) ○ Cautions: avoid during pregnancy, depression; long term use can cause  reversible yellowing of skin, hair, and nails ○ The US FDA has issued a warning that using kava supplements has been linked  to a risk of severe liver damage ○ Kava Under Scrutiny: ▪ In 2007, a safety panel of the World Health Organization (WHO) reported a  possible link between kava use and seven deaths and 14 liver transplants,  mostly in Europe ▪ But the WHO report suggested that liver toxicity may be limited to kava  formulations that used the whole kava plant, instead of just the root, or used  acetone and ethanol to extract the active ingredient from the plant instead of  water ○ Kava clinical trial published in Psychopharmacology ▪ Subjects were 37 people with GAD and depression ▪ Week 1: all patients took placebo ▪ Week 2: half took kava tablets, half took placebo ▪ Week 3: crossover, reversing week 2 ▪ Results  Based on standardized questionnaires, patients reported much less  anxiety when taking kava   Depression levels also dropped  No serious side effects observed; formulation used was a water­extract of  kava; long­term safety not addressed   St. John’s­wort ○ St. John’s­wort fam ○ Hypericum perforatum ○ Herbaceous perennial native to Europe and Asia and widely established as an  introduced species in the US ○ Leaves and flowering tops are used ○ Treats depression, anxiety (“Nature’s Prozac”) ○ Doctrine of Signatures: reddish juice and “pores” on leaf suggest flesh wounds ○ Causes photo­sensitivity ○ Scales skyrocketed in 2007 following a 20/20 story ○ Cautions: interactions with pharmaceutical drugs: MAO inhibitors, reduces blood  serum level of several drugs (including oral contraceptives) ○ Drugs that interact with St. John’s­wort: ▪ Indinavir – used to treat HIV infection ▪ Cyclosporin – tissue rejection ▪ Digoxin – heart disease ▪ Warfin – anticoagulant and a synthetic derivative of a plant coumarin found in  Sweet Woodruff, Licorice, and Lavender ▪ Oral contraceptives  Mark Blumenthal on St. John’s­wort clinical trials (video) ○ Herb­drug interactions exist; very negative reactions are possible ○ Herbs can and do interfere with the metabolism of drugs ○ Random reports of herb­drug interactions and reports from lab tests in vitro (test  tube) and petri dishes ▪ Herbal extracts and some kind of drug put together and observed how they  interacted  ▪ These studies don’t accurately and adequately approximate what happens  when you take something orally and it’s digested, as well as how herbs reach  the bloodstream  ▪ Hard to relate these studies to actual human experiences ○ Grapefruit and grapefruit juice inhibit the metabolism of something like 50% of  commercially available drugs; it increases the potency of the drugs.  St. John’s­ wort does the opposite, decreasing the potency and efficacy of drugs ○ Talk to your pharmacist.  Interview with Dr. John Gurley on the mechanism of St. John’s­wort’s interaction with many pharmaceutical drugs (video) ○ Which drug­herb interactions should healthcare providers know about? ▪ St. John’s­wort  Has a compound called hyperforin that act with a particular protein in cells.  The cell is an orphan nuclear receptor called steroid xenobiotic receptor   When hyperforin bonds to the steroid xenobiotic receptor, the combination goes to the nucleus and acts as a transcription factor; it turns on the  genes for many of the very important human drug metabolizing enzymes.  When other drugs are taken with St. John’s­wort, the drugs are  metabolized more readily and more extensively  This happens in both the intestines and liver  When you’ve taken St. John’s­wort and you have these enzymes in  you, and when you take a drug that is metabolized by those same  enzymes, the greater presence of enzymes makes metabolizing the  drug quicker ­ This results in less of the drug being absorbed into your  bloodstream  St. John’s­wort renders most medications less effective


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