Can St. John's wort be an alternative to Duloxetine?

Question

Hello doctor,

I wanted to ask you the following. I have been taking 30 mg of Duloxetine in the morning for three years. Since I have been taking it, my cholesterol has gone up (225 total and 152 bad cholesterol): perhaps this depends on the Duloxetine. In any case, I would like to try switching from Duloxetine to St. John's wort because I generally get along well with herbs. At my place, there is no Duloxetine in drops nor a dosage lower than 30 mg. I would like to know if it is possible to switch directly from Duloxetine to St. John's Wort without having any side effects or if it is necessary to first switch to another similar antidepressant that is also found in drops and then gradually reduce it and switch to St. John's Wort or if it is possible to ask a pharmacist to change the doses of microgranules contained in the individual capsules.

What do you recommend?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

As you have been on Duloxetine for a long time, it is better to reduce dosage gradually and then quit it.

I will suggest you:

To start herbal treatment with Duloxetine and then gradually reduce dosage of Duloxetine.
Initially, you need to take Duloxetine on an alternative day, and then after one month, take it every two days, and then stop it and continue your herbal treatment.
Within two months of herbal treatment, you will get good results.
You can start physical exercise daily.

Yes, Duloxetine weight gain is a problem, but you can control it with exercise.

Also, Duloxetine is available in 20 milligrams.

If it is available at your place, you can reduce it to 20 milligrams and then make it an alternative.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.