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Rutaesomn--caffeine removal aid interactions/pharmacology

Mycophile

Bluelighter
Joined
Mar 3, 2014
Messages
4,582
Hey,

So, I apologize if this is the wrong forum for this and if it is then mods, please move it to the appropriate one.

I thought it might make sense for this to go here because I want a guestimated understanding of why whatever this substance is might or might not interact badly with my meds and what my doctor could be thinking regarding neuroscience as to why there might be a chemical interaction.

Here's the background:

So, I'm having a tough time cutting down on coffee and the amount I take effects my sleep at night as we all know it does effect REM sleep.

I found this link on Amazon to a supplement called "Rutaesomn" which is supposedly made from the "evodia fruit" (never heard of it) which helps people metabolize caffeine faster so that supposedly even if you drink the same amount more of it will be out of your system by bedtime if you take it at the right time.

People on amazon who commented mostly say it is working great for them.

Here's the link:

http://www.amazon.com/Rutaesomn-Nat...=UTF8&qid=1399498548&sr=8-1&keywords=Rutasomn


The problem is: I take Klonopin and Prozac and I showed my neurologist the link and he said he "couldn't find enough info on it and it might be dangerous with my meds so not to take it".

I also could not find enough information on it online and amazon seems to be the only place selling it.

Now, I am NOT telling anyone on here to tell me to go against doctors orders, but frankly, I want a second opinion because I think my doctor is being OVERLY cautious.

Some people on here like Ebola? and Sekio might have as much knowledge or perhaps even more about drug interactions than neurologists and I'd like to hear theirs and others opinions.

I don't know much about drug interactions, but from what little I've read and experienced in taking drugs of different kind it seems unlikely such a thing would interact badly.

Firstly, it seems VERY unlikely it would interact badly with Klonopin unless of course it's some scam where this pills are actually sleeping pills and these people are sleeping better cause of that and thinking it's reducing the caffeine when it's not but that seems unlikely.


So that leaves the Prozac/SSRI. USUALLY I have heard that MAOIs are what mix badly with SSRIs or anything that greatly increase serotonin to produce serotonin syndrome.

However, I've taken all these mind altering substances like Coke, LSD, Shrooms, Salvia, Percocet, Dexedrine, bla bla....and none have interacted badly.

WHY would some supplement made from a fruit be at ALL likely to increase my serotonin to dangerous levels when all these actual mind altering substances have not?!?

I want to understand if my doctor is just "playing it safe" and I'm wondering if he's just looking online for other info (which he said he was) and NOT actually using his background in neurology to analyze whether or not there's any real likelihood that this would cause an increase or effect on serotonin or be a powerful CNS depressant.


Like I said, I know jack shit, but I want educated opinions on whether or not he sounds like he's truly analyzing the substance or just playing it safe.

I know that things which are just "natural supplements" can actually be dangerous in combo with meds...but again...I have a hard time buying that something made from a fruit to increase metabolism of caffeine would greatly effect serotonin levels or be a CNS depressant.

Any educated thoughts would be appreciated.

Thanks
 
maybe he thinks it might make the clonazepam or prozac wear off faster too? seems logical, maybe someone can tell you if it does
 
I think he is just being cautious. The active ingredient, rutaecarpine, seems to induce the liver enzymes responsible for metabolism of caffeine. These are different than the ones used to metabolize clonazepam or fluoxetine.
 
This study suggests this drug works by inducing the CYP enzymes that metabolize caffeine. While this will decrease the levels of caffeine in your blood at bed time, it will also decrease the concentration of caffeine throughout the day. Why not just consume less coffee/caffeine? That's almost the functional equivalent of taking a drug that makes you metabolize caffeine faster.

The two enzymes induced by the drug ( according to the study) are CYP1A2 and CYP2E1. These enzymes are not involved in the metabolism of klonopin/prozac, so there's no interaction there. But that doesn't necessarily mean there are no other possible interactions. I would follow your doctor's instructions not to take it.
 
Don't mess with liver enzymes unless you have to to survive.

Ok, I'm not going to use this stuff based on that statement, even though I don't have a strong understanding of how liver enzymes work.

Don't alcohol and Kava and other drugs also mess with liver enzymes?

Do you think they mess with them less than this substance?

I know I've had elevated liver enzymes in the past which my doctor told me but he didn't suggest anything or sound overly concerned since if he had been I am sure he would have let me know it was a problem.

Is it normal for liver enzymes to become elevated when a person drinks or uses certain drugs with frequency and will enzymes usually go down in time with abstinence or are elevated liver enzymes usually something to be concerned with?
 
Ok, I'm not going to use this stuff based on that statement, even though I don't have a strong understanding of how liver enzymes work.

Don't alcohol and Kava and other drugs also mess with liver enzymes?

Do you think they mess with them less than this substance?

I know I've had elevated liver enzymes in the past which my doctor told me but he didn't suggest anything or sound overly concerned since if he had been I am sure he would have let me know it was a problem.

Is it normal for liver enzymes to become elevated when a person drinks or uses certain drugs with frequency and will enzymes usually go down in time with abstinence or are elevated liver enzymes usually something to be concerned with?

When your doctor tests for "elevated liver enzymes" he's probably using that as a way to assess liver damage. When your liver is damaged it releases enzymes into the blood, but that's a separate issue from drugs that directly influence liver enzymes (like Rutasomn).

Most drugs that influence liver enzymes only affect a few different enzymes. That's usually not a cause for concern, unless you take drugs that are metabolized by the affected enzymes. The study Moredopamine linked showed two enzymes that Rutasomn affects, but this doesn't mean these are the only two enzymes affected! It may also affect enzymes involved in metabolizing your Prozac and Klonopin, or it might not, but there's no way to know for sure at this point.

Reduced effectiveness of your Prozac and Klonopin is probably the biggest concern, and I think your doctor was right to say there's not enough information to know whether you can combine these safely right now.
 
When your doctor tests for "elevated liver enzymes" he's probably using that as a way to assess liver damage. When your liver is damaged it releases enzymes into the blood, but that's a separate issue from drugs that directly influence liver enzymes (like Rutasomn).

Most drugs that influence liver enzymes only affect a few different enzymes. That's usually not a cause for concern, unless you take drugs that are metabolized by the affected enzymes. The study Moredopamine linked showed two enzymes that Rutasomn affects, but this doesn't mean these are the only two enzymes affected! It may also affect enzymes involved in metabolizing your Prozac and Klonopin, or it might not, but there's no way to know for sure at this point.

Reduced effectiveness of your Prozac and Klonopin is probably the biggest concern, and I think your doctor was right to say there's not enough information to know whether you can combine these safely right now.


Ok, I get it now.

So, regarding my past elevated liver enzymes which were probably due to drinking too much (but I'm NOT a chronic lifelong alcoholic, questionable that I'm even an alchy at all, I frequently abstain for weeks on end BUT I'm a heavy binge drinker)......if my doctor only said it in passing, and that was actually a couple years ago and I've since had blood tests where he did not bring up the issue at all....would it be safe to assume that I have not PERMANENTLY damaged my liver or my doctor would have brought it up??

I am thinking that drinking and many drugs can often STRESS the liver which TEMPORARILY produces elevated enzymes which can go back down with abstinence from damaging behaviors, but that it takes quite a long time for the damage to become PERMANENT.

Am I correct in these assumptions?
 
Ok, I get it now.

So, regarding my past elevated liver enzymes which were probably due to drinking too much (but I'm NOT a chronic lifelong alcoholic, questionable that I'm even an alchy at all, I frequently abstain for weeks on end BUT I'm a heavy binge drinker)......if my doctor only said it in passing, and that was actually a couple years ago and I've since had blood tests where he did not bring up the issue at all....would it be safe to assume that I have not PERMANENTLY damaged my liver or my doctor would have brought it up??

I am thinking that drinking and many drugs can often STRESS the liver which TEMPORARILY produces elevated enzymes which can go back down with abstinence from damaging behaviors, but that it takes quite a long time for the damage to become PERMANENT.

Am I correct in these assumptions?

Yes that's a correct assumption, and I apologize if my first post worried you. Maybe I should have said measuring liver enzymes is a way to test liver function rather than damage.

You're right though that liver damage can be temporary, and elevated liver enzymes certainly don't mean you've suffered irreversible damage. Sometimes those enzymes can be elevated without any real damage at all. Liver enzyme screens are just one of the first steps in assessing liver function, they don't really provide a definitive answer.

If there was something you should be concerned about, I'm sure your doctor would tell you, but if you're still worried there's no harm asking what those test results mean.
 
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