LETTERS: CAUTION ON HERBS

To the editor:

As a practicing pharmacist, I am concerned about a recent letter suggesting the Food and Drug Administration should not control herbal substances containing ephedra. The writer stated the drug was no more dangerous than eating rhubarb leaves. I have heard of no deaths from anyone eating rhubarb leaves, and I probably will not since individuals do not use rhubarb leaves to get high. Ephedra is used by some individuals, particularly teen-agers, to achieve a state of euphoria. When taken in high doses, or in lower doses in the presence of heart disease, the disease can cause significant health risks including death.

Other herbal remedies have medicinal properties and actions similar to prescription drugs. For instance, if an individual is feeling a little depressed, he may decide to take St.-John's-wort because he had heard it good for depression. This herb relieves the symptoms of depression because it is chemically similar to prescription monoamine oxidase inhibitors. MAO inhibitors taken with certain foods can cause a dangerously high increase in blood pressure. If you purchase an MAO inhibitor from your pharmacist, you get a list of foods you should avoid. If you purchase St.-John's-wort from a health-food store, you are not provided with this information. Also, St.-John's-wort could cause potential problems if you also went to your physician and told him you were depressed. The physician would most likely write you a prescription for Prozac or one of the newer antidepressants. When MAO inhibitors like St.-John's-wort are used with Prozac, serious and sometimes fatal reactions have occurred.

Some individuals use ephedra-containing preparations to lose weight. Individuals trying to lose weight may have high blood pressure. Ephedra would raise their blood pressure, thus increasing their risk of stroke. Herbal medicines have the same properties as prescription drugs and may pose significant risks to unwary consumers. They should be regulated by the FDA.

SHIRLEY SEABAUGH, R.Ph.

Cape Girardeau