Guest guest Posted February 6, 2003 Report Share Posted February 6, 2003 Does anyone have any information about possible herb/drug interactions? I have a patient who is on Neurontin, Wellbutrin and Serzone. I want to give her Gui Pi Tang, but she has concerns about any possible interactions. I have the A-Z Guide to Herbs & Drugs, but quite frankly, I haven't found it to be all that helpful. Thank you! Holly Boland Holly N. Boland, L.Ac. Chiro-Medical Group, Inc. 246 First Street, Suite 101 San Francisco, CA 94105 T: (415) 495-2225 C: (415) 531-5602 The new MSN 8: smart spam protection and 2 months FREE* Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2003 Report Share Posted February 7, 2003 Holly: Before you read this, I have to confess there is no answer to your question in my response. The only book in my libarary which specifically addresses the question has no answer. But since all you have at hand is the A-Z Guide, it might be helpful to at least share a bibliography of what I am aware is available in the way of reference books on the subject in general. The first in the list is the only book I know of which specifically addresses Chinese herb and pharmaceutical interactions (and it listed nothing for Gui Pi). Chan, Cheung, INTERACTIONS BETWEEN CHINESE HERBAL MEDICINAL PRODUCTS AND ORTHODOX DRUGS, Harwood 2000. Brinker, HERB CONTRAINDICATIONS AND DRUG INTERACTIONS, Eclectic Medical Publications 2001 Brinker, THE TOXICOLOGY OF BOTANICAL MEDICINES , Eclectic Medical Publications 2000 Cupp, TOXICOLOGY AND CLINCAL PHARMACOLOGY OF HERBAL PRODUCTS , Humana 2000 McGuffin, & al, AMERICAN HERBAL PRODUCTS ASSOCIATIONS BOTANICAL SAFETY HANDBOOK, CRC 1997 Harkness, Bratman, DRUG HERB VITAMIN INTERACTIONS BIBLE, Prima 2000. The above books (as well as the A-Z Guide to Herbs & Drugs) are what I keep on hand in my library (along with the Ibis Interactions program on my computer and, of course, the standard materia medica which do include some warnings in their monographs) to check out possible interactions, and they are really inadequate. As noted, only the first title, a very slim volume which frustrates as often as it informs, specifically addresses Chinese herbs and it is more of a start than a standard. There is really a long overdue need for a comprehensive reference (be it book or website) on Chinese herb/drug/supplement contraindications and interactions, as today's dang gui postings illustrates.Even the MDs who are not prejudiced against herbs have nowhere to look to get reassurance or a timely warning. Or am I missing some available resource? Is anyone pursuing such a worthy and badly needed publication project? Neal White. - Holly N. Boland Thursday, February 06, 2003 8:01 PM Gui Pi Tang & anti-depressants Does anyone have any information about possible herb/drug interactions? I have a patient who is on Neurontin, Wellbutrin and Serzone. I want to give her Gui Pi Tang, but she has concerns about any possible interactions. I have the A-Z Guide to Herbs & Drugs, but quite frankly, I haven't found it to be all that helpful. Thank you! Holly Boland Holly N. Boland, L.Ac. Chiro-Medical Group, Inc. 246 First Street, Suite 101 San Francisco, CA 94105 T: (415) 495-2225 C: (415) 531-5602 The new MSN 8: smart spam protection and 2 months FREE* Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2003 Report Share Posted February 7, 2003 Gui Pi Tang, but she has concerns about any possible interactions. I have the A-Z Guide to Herbs & Drugs, but quite frankly, I haven't found it to be all that helpful >>No problem done it many many times. This drug combination is quite common in pain patients alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2003 Report Share Posted February 17, 2003 Holly, This seems to be a challenging situation, with the combination of strong medications. While I don't think you have to worry about herb-drug interactions, especially when using a complex prescription, you need to look for possible masking of symptoms. Secondly, why do you want to give gui pi tang? If the prescription is correct, this will minimize any problems, but what are you treating? What is your pattern diagnosis, tongue and pulse, symptoms? I wouldn't give gui pi tang automatically to a patient because of their biomedical diagnosis, although I cannot assume that from what you've presented here. On Thursday, February 6, 2003, at 05:01 PM, Holly N. Boland wrote: > Does anyone have any information about possible herb/drug > interactions? I have a patient who is on Neurontin, Wellbutrin and > Serzone. I want to give her Gui Pi Tang, but she has concerns about > any possible interactions. I have the A-Z Guide to Herbs & Drugs, but > quite frankly, I haven't found it to be all that helpful. > > Thank you! > > Holly Boland Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2003 Report Share Posted February 17, 2003 , " Holly Boland " wrote: > > Does anyone have any information about possible herb/drug > > interactions? I have a patient who is on Neurontin, Wellbutrin and Serzone. I want to give her Gui Pi Tang, but she has concerns about any possible interactions. I have the A-Z Guide to Herbs & Drugs, but quite frankly, I haven't found it to be all that helpful. Holly: My anxiety formula is a modified combination of Gui Pi Tang and Wen Dan Tang which I've given to a wide variety of patients on the meds you ask about. With it, they've been able to decrease or discontinue those meds. So far, there has been no negative interaction; nor have I seen anything in the literature about combining them. My only recommendation to patients is that they take it at a different time of day than their meds. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2003 Report Share Posted February 17, 2003 I find doing it this way requires few herbal formulas tailored to the individual, and allows a more general approach. The more individualized work can be done with acupuncture. > My anxiety formula is a modified combination of Gui Pi Tang and Wen > Dan Tang which I've given to a wide variety of patients on the meds > you ask about. With it, they've been able to decrease or discontinue > those meds. So far, there has been no negative interaction; nor have > I seen anything in the literature about combining them. > > My only recommendation to patients is that they take it at a > different time of day than their meds. Jim, So is this an example of how you treat patients herbally? Are you more specific with the acupuncture and moxabustion, as you implied in your earlier post today, and more general with the herbs? I like this combination, and have used it myself, but there are several other scripts that could be considered based on the pattern(s). What other prescriptions do you use with patients who complain of anxiety? On Monday, February 17, 2003, at 04:36 PM, James Ramholz <jramholz wrote: > > > > Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 , " " wrote: > So is this an example of how you treat patients herbally? Z'ev: My Anxiety formula has 32 herbs in it, so it not only addresses the Zang/fu vacuity patterns in TCM. It has been very successfully used for a number of years. It includes: Bai shao, Bai zhu, Bai zi ren, Ban xia, Bo he, Chai hu, Chuan xiong, Dan shen, Dang gui, Fu ling, Fu shen, Gan cao, Gu qi zi, Huang lian, Jie geng, Long yan rou, Mai men dong, Mu dan pi, Mu xiang, Niu xi (huai), Ren shen, Sha ren, Shan zi, Shi chuang pu, Shu di huang, Suan zao ren, Tian nan xing, Wu wei zi, Xuan shen, Yuan zhi, Zhi shi, and Zhu ru. In the Dong Han system, we look at anxiety from a different perspective. Vacuity patterns (Liver-spleen disharmony, Heart-spleen vacuity, and Lung-spleen qi vacuity) alone are not sufficient to explain anxiety. Vacuity itself is a relatively simple issue to resolve. So, if left with only the vacuity patterns themselves, the question arises as to why one patient develops anxiety and another with the same diagnosis develops digestive, insomnia, or respiratory problems. In the pulses we find a fairly common pulse dynamics---not solely vacuity---related to the interaction between organs; much in the way that Manaka was speaking about it in his book. That dynamic exchange is the information that body uses for control its functions and self- organization. One major pulse pattern in the dynamics for anxiety, we see a movement from the SJ to the spleen and irregularly reversing back to the SJ at a deeper level; then the SJ sends it out to the LI. I first saw this pattern a number of years ago in a woman who was dreading a visit by her mother. In ambivalently attached individuals, states are easily fragile and unstable. This pulse patterns underscores that picture. How often, regular, and fast this pattern occurs helps determine the intensity of the anxiety. How deep in the positions you find this pattern tells you how long this anxiety has existed in their history. Fairly frequently (about 20% of the time), we find this pattern going back to childhood. After around 7-8 years old, the pattern becomes an adapted feature and the patient isn't always aware of this undercurrent in their later life, as consciousness itself isn't required for information processing. They think they have outgrown those childhood patterns but haven't. It's always fun to point out to students and practitioners at seminars. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 These aren't the only patterns associated with anxiety in the CM literature. Most modern anxiety patterns are mixtures of vacuity and repletion. . . just think of how debilitating to blood and qi anxiety attacks are, but think about how much repletion accompanies them. I find Li-Zhu theory to be a very good approach to anxiety, because it treats multi-pattern issues with the core at the spleen and stomach. On Tuesday, February 18, 2003, at 02:03 AM, James Ramholz <jramholz wrote: > In the Dong Han system, we look at anxiety from a different > perspective. Vacuity patterns (Liver-spleen disharmony, Heart-spleen > vacuity, and Lung-spleen qi vacuity) alone are not sufficient to > explain anxiety. Vacuity itself is a relatively simple issue to > resolve. So, if left with only the vacuity patterns themselves, the > question arises as to why one patient develops anxiety and another > with the same diagnosis develops digestive, insomnia, or respiratory > problems. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 What I perceive is that you are speaking about the informational level of the body, i.e. the channels and connecting vessels. You are talking about movements between systems as detected on the pulse. This is perhaps why you use more precision and variation in your point prescriptions than with herbal prescriptions, which rely more on visceral-bowel patterns. There are subtle differences with these approaches (herbal medicine and acupuncture/moxabustion), and they need to be diagnosed and treated differently in many cases. I also find that most anxiety is rooted in childhood, patterns that become automatic responses to stress. I feel that acupuncture can help change those patterns, sometimes dramatically, and herbal medicine can support internal changes. Cognitive therapies are also good ways to teach the patient new ways to respond to events. On Tuesday, February 18, 2003, at 02:03 AM, James Ramholz <jramholz wrote: > In the pulses we find a fairly common pulse dynamics---not solely > vacuity---related to the interaction between organs; much in the way > that Manaka was speaking about it in his book. That dynamic exchange > is the information that body uses for control its functions and self- > organization. One major pulse pattern in the dynamics for anxiety, > we see a movement from the SJ to the spleen and irregularly > reversing back to the SJ at a deeper level; then the SJ sends it out > to the LI. I first saw this pattern a number of years ago in a woman > who was dreading a visit by her mother. In ambivalently attached > individuals, states are easily fragile and unstable. This pulse > patterns underscores that picture. > > How often, regular, and fast this pattern occurs helps determine the > intensity of the anxiety. How deep in the positions you find this > pattern tells you how long this anxiety has existed in their > history. Fairly frequently (about 20% of the time), we find this > pattern going back to childhood. After around 7-8 years old, the > pattern becomes an adapted feature and the patient isn't always > aware of this undercurrent in their later life, as consciousness > itself isn't required for information processing. They think they > have outgrown those childhood patterns but haven't. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 , " " <zrosenbe@s...> wrote: > These aren't the only patterns associated with anxiety in the CM > literature.>>> Z'ev: I just listed them as an example because I had the Flaws/Lake book open. If anxiety (or other disorder) was only a vaciuty and repletion problems, it wouldn't be hard to treat. I mention Manaka earlier because it is in line with what we do. Unfortunately, Manaka seems to draw little interest now. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 He certainly draws interest with me. He was one of the great innovators in Chinese medicine in the 20th century, and his book " Chasing the Dragon's Tail " is still one of the best English language texts on acupuncture/moxabustion. On Tuesday, February 18, 2003, at 04:41 PM, James Ramholz <jramholz wrote: > I mention Manaka earlier because it is in line with what we do. > Unfortunately, Manaka seems to draw little interest now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2003 Report Share Posted February 18, 2003 , " " wrote: > He certainly draws interest with me. >>> Z'ev: As he does me. But there are only a few links on the Internet to his X-signal system. Who is continuing to develop his ideas now? Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2003 Report Share Posted February 19, 2003 I'll have to ask Bob Felt or Stephen Birch about that. On Tuesday, February 18, 2003, at 10:57 PM, James Ramholz <jramholz wrote: > > Z'ev: > > As he does me. But there are only a few links on the Internet to his > X-signal system. Who is continuing to develop his ideas now? > > > Jim Ramholz > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2003 Report Share Posted February 19, 2003 I've already sent Bob Felt a note. Jim , " " <zrosenbe@s...> wrote: > I'll have to ask Bob Felt or Stephen Birch about that. > > > On Tuesday, February 18, 2003, at 10:57 PM, James Ramholz > <jramholz> wrote: > > > > > Z'ev: > > > > As he does me. But there are only a few links on the Internet to his > > X-signal system. Who is continuing to develop his ideas now? > > > > > > Jim Ramholz > > Quote Link to comment Share on other sites More sharing options...
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