To the Editor

Recently, a patient reporting to our Ambulatory Surgery Center told two of our astute nurses that she was taking “St. John’s Wort,” an OTC “herbal” anti-depressant. Upon investigation, we have discovered the active ingredient is hypericum, a strong inhibitor of MAO, types A and B.

Although I had not heard of St. John’s Wort, I have found it is a commonly used, popular OTC remedy billed as “Nature’s Prozac” and it has been discussed on several network TB shows and reports and even in our local “fish wrapper” (newspaper). After the recent problems with Fen/Phen, I feel that the anesthesia community should be aware of the potential problems that could be presented by patients taking this drug (for that is what it is) who undergo anesthesia.

Rick Ciordia, M.D. Medical Director, Ambulatory Surgery Center West Florida Medical Center, Pensacola