Dear Mr. Tisserand,
I was treating a young woman with back pain recently. This young woman is on selective serotonin re-uptake inhibitor (SSRI) type of anti-depressant medication. Because her pain was acute I used a 10% blend on the specific site of pain that included German chamomile, black pepper, ginger and everlasting. About 30 minutes after the application she vomited and told me she suspected the essential oils may have caused her to be sick. She mentioned serotonin syndrome which is caused by an overload of serotonin in her system.
I referred to quite a few texts (including your book) and could not find any contraindications listed. I did find some notes that my aromatherapy lecturer gave me that states chamomile, lavender, marjoram, and neroli have the action of releasing seratonin in the system when used.
Are there any active chemicals (eg linalool or some other) that might have this effect that you are aware of? I would appreciate any help you could provide.
Kind regards
-Liliana
Dear Liliana,
Tough question. I wonder how much total oil you applied to her body? And what proportions you used of each oil? Only about 10% of that would be absorbed by the skin, so 10% EO applied becomes 1% EO absorbed. It’s then a matter of whether enough oil got into her bloodstream to provoke such a strong non-local reaction. It’s not impossible.
Some oils do affect serotonin directly, but not massively. It’s more likely that an oil/constituent increased the SSRI effect (so indirectly causing a further increase in serotonin), if indeed the essential oils were responsible for her vomiting. The only ones known to interact badly with SSRI drugs are eugenol-rich oils (such as clove) and myristicin-rich oils (such as nutmeg), and you used none of those. These two constituents are monoamine oxidase (MAO) inhibitors, which can cause this interaction with SSRI drugs.
If it was something you used, I would guess that it’s not the black pepper or ginger, which are rich in terpenes.
-Robert
Hi Robert
Thank you so much for your quick reply!
What you have said makes a lot of sense. In answer to your question: I did not give her a full body massage. I massaged the oils directly on the area, about 25 x 30 cm of her back to treat muscular inflammation. In 15 ml of carrier oil I mixed 12 drops German chamomile, 6 drops ginger, 6 drops black pepper and 6 drops everlasting (and not all of the oil was used up).
Thank you so much for your assistance.
Kind regards
-Liliana
In conclusion – very little essential oil, equivalent to 1 or 2 drops maximum, would enter the bloodstream from this treatment. If one of the oils did interact with the SSRI medication, it must be quite a potent MAO inhibitor.
Any thoughts on the possibility that the aroma of the oils were a contributing
factor?
I have run into a similar situation with a client who was newly prescribed a triptan med for chronic migraines. Triptans are known to cause heavy serotonin release in some individuals, which can manifest as cardiac palpitations. My client frequently diffuses lavender in both home and office, and his first week on the drug, he took his medication after having diffused lavender for several hours, then suffered dizziness, shortness of breath and heart palpitations very shortly thereafter (all signs of serotonin syndrome). He does have uncontrollable HBP and a family history of severe cardiac problems, and I am surprised that his physician prescribed triptans since that is a known caution with those meds. I’ve always wondered if in this instance, the lavender was a contributing factor to his episode. In any event, I asked him to temporarily avoid use of lavender and Roman chamo, and he went off the meds after just 2 weeks, so there’s no telling…
Dear Robert,
Having read the above, I would be very interested in knowin whether lavender can indeed intereact with some anti-depressants as quite a number of pregnant women have used / are using antdepressants.
Thank you.
PS The discovery of this weblink is very interesting!
Ingrid – it’s not impossible, but has not been tested.