Q. Hi, I was wondering if 5-htp and sam-e and st johns wort have same risk of mania as prozac? Also I was wondering if there are any herbs to help psychotic symptoms? I am DXd with schizoaffective and would rather go with natural remedies than chemical. thank you for any information you can give me....... Jesse .

A. 5-htp and SAMe - mania is reported as a "rare" side effect for 5-htp and seems to be a more common side effect in SAMe. You may also cycle more rapidly.

St. John's Wort is traditionally used for depression, anxiety, and mania, but there are reports of St. John's wort inducing mania.

Nutritional healing suggests that for psychotic and mood disorders you increase essential fatty acids, magnesium, vitamin C, and the B vitamins, while eliminating foods that you may be allergic or sensitive to - most often gluten, food colours, corn (especially high-fructose corn syrup), preservatives, etc. If you take a fatty acid supplement, I would suggest fish oil rather than flax oil, as there appears to be a much lower risk of mania. Magnesium is used to treat severe mania. B vitamins and zinc work together to regulate neurotransmitters. Vitamin C is supposed to be particularly helpful for schizoid disorders. You should avoid alcohol, smoking, and coffee if you can. They can worsen symptoms and also decrease the nutrients that your body needs to battle these disorders.

Make sure that you get enough sleep. Sleep deprivation greatly aggravates psychosis. Some of the herbs listed below, such as lavender, can help.

Herbs that may help psychosis and not trigger mania:

- Ginkgo (do not take it if you have a bleeding disorder or are on MAOI's)

- Skullcap (possible side effects confusion, irregular heartbeat, liver damage)

- Lobelia (may increase antidepressents' actions)

- Rosemary (do not take if you are on seizure medication or prone to seizures)

- Oatstraw herb

- Vervain (do not take if you are on blood pressure meds)

- Lavender (may increase antidepressents' actions)

Music therapy is also touted as helping with psychosis, humming is supposed to be particulary successful against auditory hallucinations.

Exercise can also help alleviate symptoms of psychosis and mood disorders

- Pam